Development of a Multifunctional Detoxifying Unit for Liver Failure Patients

Abstract

Background/Aims: Extracorporeal blood detoxification strategies aimed at supporting impaired liver function have been explored because of the imbalance between donor organs and waiting patients. A limited number of artificial devices are now available clinically, and these are characterized by the use of multistage adsorption procedures in conjunction with hemodialysis, but these features simultaneously increase system complexity and treatment costs. Methods: The authors developed a simpler strategy for liver dialysis based on the use of a multifunctional filter, which enables plasma separation and perfusion in a single unit. Results: Liver dialysis treatments were successfully performed using the devised unit when bovine blood containing uremic and hepatic toxins was circulated. Removal of the solutes under investigation was significant, and reduction ratios of 78% for urea, 98% for creatinine and 91% for bilirubin were achieved. Plasma free hemoglobin levels were reasonably maintained despite prolonged blood recirculation for 5 h, and platelet, hematocrit and hemoglobin levels remained uniform throughout liver dialysis sessions. Conclusion: The devised liver support unit may offer a straightforward and efficient means of cleansing blood for patients with hepatic failure.

Prometheus therapy for the treatment of acute liver failure in patients after cardiac surgery

“…According to many authors, the impact of extracorporeal blood purification methods on survival rate in ALF was statistically insignificant [ 19 , 20 ].…”

Extracorporeal Blood Purification in Intensive Therapy of Acute Liver Failure

“…Принцип метода основан на абсорбции, которая заключается в том, что молекулы атомов или ионы диффундируют внутрь адсорбента и адсорбции, когда молекулы атомов или ионы осаждаются на поверхности [13]. Однако каким бы безопасным ни был угольный гемосорбент, при его использовании все же имеют место определенные осложнения, такие как легкая тромбоцитопения, истощение фибриногена, уменьшение лейкоцитов, гипотензии, гипогликемия, элиминации гормонов и факторов коагуляции [14]. Следует сказать, что угольные гемосорбенты не обладают селективностью и связывают из крови как токсины, так и «нужные» организму вещества [15].…”