Continuous veno-venous single-pass albumin hemodiafiltration in children with acute liver failure*

Abstract

In childhood acute liver failure, treatment with single-pass albumin dialysis was generally well tolerated and seems to be effective in detoxification and in improving blood pressure, thus stabilizing the critical condition of children before liver transplantation and facilitating bridging to liver transplantation. It may be beneficial in avoiding severe neurologic sequelae after acute liver failure and thereby improve survival. Single-pass albumin dialysis is an inexpensive albumin-based detoxification system that is easy to set up and requires little training. Whether and to what extent single-pass albumin dialysis can support children with acute liver failure until native liver recovery remains unclear.

Prognostic parameters of pediatric acute liver failure and the role of plasma exchange

“…Fewer studies of liver support devices have focused on pediatric patients than on adults, and those that have are mainly case series or retrospective studies. Those studies reported improvements in biochemical parameters, neurological status, and hemodynamic stability in children, 12,14,18,19 but no randomized controlled trials have supported the benefits of any liver support devices.…”

Continuous molecular adsorbent recirculating system treatment in 69 patients listed for liver transplantation

“…There are extracorporeal circuits other than MARS. However, neither the Prometheus system (Fresenius GmBH) [ 30 ], single-pass albumin dialysis [ 31 ] or plasma exchange therapy [ 32,33 ] have been able to show improved survival rates as compared to standard medical therapy, and there is no convincing evidence suggesting that one of the methods is superior compared to others [ 5 ]. Although refining existing methods by e.g.…”

Albumin Dialysis for Liver Failure: A Systematic Review

“…9 This liver support system has shown some promise in a case series of children with acute liver failure. 10 The Prometheus system is a variant of albumin dialysis and combines fractionated plasma separation, adsorption, and hemodialysis. 11 It uses a 250-kDa semipermeable membrane generating an albumin-containing plasma-like solution.…”