Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Zhou, Ning; Li, Jianzhou; Zhang, Yimin; Lü, Juan; Chen, Ermei; Du, Wenli; Wang, Jie; Pan, Xiaoping; Zhu, Danhua; Yang, Ying; Chen, Yu; H, Cao; Li, Lanjuan

doi:10.1016/j.jhep.2015.03.018

Cited by 32 publications

(46 citation statements)

References 63 publications

(59 reference statements)

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“…Cerebral edema is a characteristic and feared complication of ALF that can result in uncal herniation and brain death . Cerebral edema has been strongly associated with blood ammonia levels, and survival benefits with reduction in ammonia levels in large animal ALF models have been demonstrated previously . Our data support these prior results, namely, that 200‐g SRBAL treatment reduced blood levels of ammonia significantly throughout the entire 24‐hour treatment interval compared with the 0‐g and SMT groups.…”

Section: Discussionsupporting

confidence: 89%

“…First‐generation devices have undergone clinical trials but thus far have failed to demonstrate a survival benefit over controls in randomized clinical trials . Newer generation devices have been modified to increase cell numbers and improve detoxification in large animal ALF models . One such device is the spheroid reservoir bio‐artificial liver (SRBAL), which showed a survival benefit and was associated with both a significant lowering of blood ammonia levels and a neuroprotective effect with reduced cerebral edema formation in a drug‐induced ALF model .…”

mentioning

confidence: 99%

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Randomized Trial of Spheroid Reservoir Bioartificial Liver in Porcine Model of Posthepatectomy Liver Failure

et al. 2018

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Randomized Trial of Spheroid Reservoir Bioartificial Liver in Porcine Model of Posthepatectomy Liver Failure

et al. 2018

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“…Many different drug models (e.g., those created using D-galactosamine, acetaminophen, carbon tetrachloride, amanitin, concanavalin A, lipopolysaccharide, thioacetamide, and nitrosamines) have been described in the literature [18–23]. The greatest advantage of drug models is that no anesthetics and complex operations are required.…”

Section: Discussionmentioning

confidence: 99%

Establishment of a Novel Simplified Surgical Model of Acute Liver Failure in the Cynomolgus Monkey

Cai

Weng

Feng

et al. 2016

BioMed Research International

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Models using large animals that are suitable for studying artificial liver support system (ALSS) are urgently needed. Presently available acute liver failure (ALF) models mainly involve pigs or dogs. Establishment of current surgical ALF models (hepatectomy/devascularization) requires either very good surgical skills or multistep processes—even multiple stages of surgery. Therefore, it is necessary to develop a simplified surgical method. Here we report a novel simplified surgical ALF model using cynomolgus monkeys. Six monkeys underwent portal-right renal venous shunt combined with common bile duct ligation and transection (PRRS + CBDLT). Postoperatively, the monkeys had progressively increased listlessness, loss of appetite, and obvious jaundice. Blood biochemistry levels (Amm, ALT, AST, TBiL, DBiL, ALP, LDH, CK, and Cr) and prothrombin time (PT) were significantly increased (all P < 0.01) and albumin (ALB) was markedly reduced (P < 0.01) compared with baseline values. Histological examination of liver specimens on postoperative day 10 revealed cholestasis and inflammation. PRRS + CBDLT produced ALF that closely correlated with clinical situations. Compared with other surgical or drug ALF models, ours was simplified and animals were hemodynamically stable. This model could provide a good platform for further research on ALSS, especially regarding their detoxification functions.

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“…This approach seeks to benefit from the more comprehensive detoxification achieved by TPE compared to MARS, without need for a supply of exogenous fresh frozen plasma because the patient's plasma is returned after detoxification. In a D‐galactosamine pig model of ALF, Li‐ALS resulted in an improvement in survival compared to treatment with low‐volume TPE alone and to treatment with the modified MARS circuit alone …”

Section: Emerging Technologies In Elsdsmentioning

confidence: 98%

Extracorporeal liver support devices for listed patients

Lee¹,

Stadlbauer

Jalan

2016

Liver Transpl

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An alternative to liver transplantation for patients with liver failure remains an unmet need. In acute liver failure, the ideal extracorporeal liver support device (ELSD) would replace the functions of the failing liver in order to permit spontaneous recovery, given the incredible regenerative potential of the liver, negating the need for transplantation. In acute‐on‐chronic liver failure, an ELSD would ideally support hepatic function until a recovery to liver function before acute decompensation or until liver transplantation. In decompensated cirrhosis, an ELSD could again be used to support hepatic function until transplant. In addition, ELSDs may have the potential to treat the multiorgan failure that accompanies liver failure including hepatic encephalopathy, renal failure, and immune dysfunction or indeed potential to promote liver regeneration. Creation of an extracorporeal bioartificial liver able to completely replace liver function remains an unmet need. This review will describe a number of technologies suitable for clinical trials in humans, which have resulted from decades of engineering and biological research to develop a bioreactor able to adequately sustain functional hepatocytes. In addition, this review will describe artificial liver support devices that are primarily designed to replace the detoxifying functions of the liver and will consider the current data available or studies required to support their use in liver failure patients on the transplant waiting list. Liver Transplantation 22 839–848 2016 AASLD.

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Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

Cited by 32 publications

References 63 publications

Randomized Trial of Spheroid Reservoir Bioartificial Liver in Porcine Model of Posthepatectomy Liver Failure

Randomized Trial of Spheroid Reservoir Bioartificial Liver in Porcine Model of Posthepatectomy Liver Failure

Establishment of a Novel Simplified Surgical Model of Acute Liver Failure in the Cynomolgus Monkey

Extracorporeal liver support devices for listed patients

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