Charcoal Hæmoperfusion in the Treatment of Fulminant Hepatic Failure

Gazzard, B. G.; Weston, Michael; Murray-Lyon, I M; Flax, H.; Record, C. O.; Portmann, Bernard; Langley, P. G.; Dunlop, Eric H.; Mellon, P. J.; Ward, Melea; Williams, Roger

doi:10.1016/s0140-6736(74)90678-3

Cited by 241 publications

(48 citation statements)

References 13 publications

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“…It should be noted in addition, however, that with the exception of this report, no case of fulminant Wilson's disease has been reported to survive to date without OLTx. It should also be noted that only those who use less restrictive definitions of fulminant and subacute hepatic failure (e.g., not requiring the obligate presence of deep Stage 3 or Stage 4 coma) have reported survival rates of between 33 and 70%, which are comparable to what we have found in advanced stages of hepatic encephalopathy (1,3,5,10,(23)(24)(25)(26)(27)(28). Clearly, the role of liver transplantation in patients having less severe fulminant or subacute hepatic dysfunction but not in advanced Grade 3 or 4 hepatic encephalopathy but rather in Stage 2 and early Stage 3 remains to be determined.…”

Section: Discussionsupporting

confidence: 81%

Orthotopic liver transplantation for acute and subacute hepatic failure in adults

et al. 1987

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The role of liver transplantation in 29 patients with fulminant and subacute hepatic failure due to a variety of different causes was examined by comparing the outcome and a variety of "hospitalization" variables. Transplanted patients (n = 13) were more likely to survive (p < 0.05), were younger (p < 0.05) and spent more time in the hospital (p < 0.025) than did those who were not transplanted (n = 16). Despite spending a much longer time in the hospital, transplaRted patients spent less time in the intensive care unit (p < 0.05) in coma (p < 0.01) and on a respirator (p < 0.01) than did ~hose not transplanted. Most importantly, the survival rate for transplanted patients was significantly improved (p < 0.05) as compared to those not transplanted. We conclude that liver transplantation can be applied successfully to the difficult clinical problem of fulminant and subacute hepatic failure.Fulminant and subacute hepatic failure are major clin--ical problems in hepatology because of the uniformly poor prognosis experienced by its victims. Most series report mortality figures ranging between 80 to 100% with the majority reporting survival rates of only 5 to 10% (1-6).

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Section: Discussionsupporting

confidence: 81%

Orthotopic liver transplantation for acute and subacute hepatic failure in adults

et al. 1987

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“…Kiley et al (1956) were the first to employ the dializer for the removal of blood ammonia. Chang (1972) and Gazzard et al (1974) carried out hemoperfusion over coated charcoal in patients with hepatic coma. Opolon et al (1976) performed hemodialysis with a high-permeable membrane with polyacrylonitorile to remove middle molecule toxins, and plasma exchange was first used by Lepore and Martel (1967).…”

Section: Discussionmentioning

confidence: 99%

Blood purification of bilirubin and bile acids by plasma exchange for patients with liver failure.

Matsubara

Okabe

Ouchi

et al. 1986

Tohoku J. Exp. Med.

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“…Microencapsulation stops ®ne particles of charcoal escaping into the circulation, thus improving its biocompatibility. Gazzard et al 35 reported the use of charcoal haemoperfusion in 22 cases of AHF with grade IV hepatic coma in an uncontrolled trial. Recovery of consciousness and improved survival was demonstrated.…”

Section: ±58mentioning

confidence: 99%

Review article: liver support systems in acute hepatic failure

Rahman¹,

Hodgson²

1999

Aliment Pharmacol Ther

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The treatment of acute hepatic failure has developed rapidly over the last 40 years, reducing morbidity and mortality from this syndrome. Whilst this has been partly attributed to significant improvements in the specialist medical management of these patients, advances in surgical techniques and pharmaceutical developments have led to the establishment of successful liver transplantation programmes, which have improved mortality significantly.This review will examine the clinical impact of alternative methods that have been used to provide extra‐corporeal hepatic support. Non‐biological, bio‐ logical and hybrid hepatic extra‐corporeal support will be explored, offering a comprehensive historical overview and an appraisal of present and future advances.

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Charcoal Hæmoperfusion in the Treatment of Fulminant Hepatic Failure

Cited by 241 publications

References 13 publications

Orthotopic liver transplantation for acute and subacute hepatic failure in adults

Orthotopic liver transplantation for acute and subacute hepatic failure in adults

Blood purification of bilirubin and bile acids by plasma exchange for patients with liver failure.

Review article: liver support systems in acute hepatic failure

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