Albumin Dialysis for Liver Failure: A Systematic Review

Tsipotis, Evangelos; Shuja, Asim; Jaber, Bertrand L.

doi:10.1053/j.ackd.2015.05.004

Cited by 80 publications

(60 citation statements)

References 30 publications

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“…This system consists of two circuits: one for conventional high-flux haemodialysis, and one module for protein-bound substances depuration 26. However, although it appears to be a technology with few side effects and satisfactory performance,26 27 the available evidence remains poor 28. Moreover, this technique was not available in our unit.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity

et al. 2016

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We report a case of a 37-year-old man with Maturity Onset Diabetes of the Youth (MODY) type 5, admitted for an episode of cholestasis and a simultaneous acute kidney injury (AKI). Chronic liver disease was due to a mutation in the transcription factor 2 (TCF2) gene, thus highlighting the need for a close liver follow-up in these patients. AKI was attributed to a cholemic nephropathy based on the following rationale: (1) alternative diagnoses were actively ruled out; (2) the onset of AKI coincided with the onset of severe hyperbilirubinaemia; (3) renal pathology showed large bile tubular casts and a marked tubular necrosis and (4) creatinine serum dramatically decreased when bilirubin levels improved after the first sessions of extracorporeal albumin dialysis (ECAD), thus suggesting its role in renal recovery. Even though cholestasis can precipitate renal injury, the diagnosis of cholemic nephropathy could require a renal biopsy at times. Future studies should confirm the benefits of ECAD in cholemic nephropathy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity

et al. 2016

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“…ALB, synthesized by liver cells and secreted into the circulatory system, is the most abundant protein in the plasma of healthy human beings. This protein is the most commonly used and most reliable indicator of liver cell function, as very little is produced by cells of other tissues (Kahraman et al, 2014;Tsipotis et al, 2015). The liver's ability to metabolize amino acids is facilitated by the synthesis of urea from ammonia and subsequent renal excretion.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of bone mesenchymal stem cells into hepatocyte-like cells induced by liver tissue homogenate

2016

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ABSTRACT. This study investigated the efficacy and feasibility of inducing the differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) into hepatocyte-like cells in vitro using Sprague Dawley rats, as a model of hepatocyte generation for cell transplantation. BMSCs were isolated and grown using the adherent method and exposed to 5 or 10% liver tissue homogenate, before being collected for analysis after 0, 7, 14, and 21 days. Immunofluorescence and western blotting were employed to detect the liver-specific markers a-fetoprotein (AFP) and albumin (ALB). Supernatant urea content was also measured to verify that differentiation had been induced. After 7 days in the presence of 10% liver tissue homogenate, BMSCs demonstrated hepatocyte-like morphological characteristics, and with prolonged culture time, liverspecific markers were gradually produced at levels indicating cell maturation. AFP expression peaked at 14 days then began to decrease, while both urea and ALB levels increased with induction time. Overall, 2 X.K. Xing et al. Genetics and Molecular Research 15 (3): gmr.15038550 marker expression in the 5% homogenate group was less than or equal to the 10% group at each time point. Thus, in a rat model, liver tissue homogenate obtained from partial hepatectomy can induce the differentiation of BMSCs into hepatocyte-like cells. This method is simple, feasible, and has remarkable real-world application potential.

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“…In patients with evidence of cerebral edema, administration of mannitol or hypertonic saline would be warranted. Besides, albumin dialysis (e.g., molecular adsorbent recirculating system) is an extracorporeal liver support system that is primarily used as a bridge therapy for patients with liver failure awaiting liver transplantation or recovery [8][9][10].…”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Expanding the Boundaries of Combined Renal Replacement Therapy for Non-Renal Indications

Kamboj

Kazory²

2018

Blood Purif

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Over the last decades, there have been major advancements in the field of renal replacement therapy (RRT) with utilization of newer technologies and advent of various modalities. Once exclusively used for treatment of renal failure and its metabolic consequences, the science of RRT has expanded to include non-renal indications such as treatment of fluid overload in patients with refractory heart failure. Hepatic encephalopathy due to sudden rise in serum ammonia level in the setting of acute liver failure represents an underexplored area in which RRT can potentially be helpful. While the key role of hyperammonemia in the pathogenesis of hepatic encephalopathy in patients with liver failure is well established, emerging data points to distinct pathophysiologic mechanisms underlying chronic alterations in neural metabolic functions and acute changes in cerebral perfusion. In the acute setting, ammonia can cross the blood–brain barrier at high levels leading to sudden formation of strong osmolytes, significant transcellular shift of water, and cerebral edema. Herein, we provide a brief overview of the role of RRT in management of acute hyperammonemia in the setting of acute liver failure and discuss the practical aspects of the available therapeutic modalities. Larger studies are needed to shed light on a number of clinical aspects such as the impact on the outcomes, criteria for selection of the patients that would benefit most from this therapeutic approach, optimal timing of initiation of RRT, and the most appropriate modality.

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Albumin Dialysis for Liver Failure: A Systematic Review

Cited by 80 publications

References 30 publications

Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity

Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity

Differentiation of bone mesenchymal stem cells into hepatocyte-like cells induced by liver tissue homogenate

Expanding the Boundaries of Combined Renal Replacement Therapy for Non-Renal Indications

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