Long‐Term Survivors with Artificial Liver Support in Fulminant Hepatic Failure

Nitta, Masakazu; Hirasawa, Hiroyuki; Oda, Shigeto; Shiga, Hidetoshi; Nakanishi, Koji; Matsuda, Kazuo; Nakamura, Masataka; Yokohari, Kennji; Hirano, Takeshi; Hirayama, Yoh; Moriguchi, Takeshi; Watanabe, Eizou

doi:10.1046/j.1526-0968.2002.00434.x

Cited by 15 publications

(11 citation statements)

References 23 publications

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“…As a promising liver assist system, ALSS can perform partial functions of liver, with important therapeutic potentials in various patients with hepatitis, liver cirrhosis, and acute liver failure [17], [18]. ALSS treatment seemed to reduce the mortality in patients with ACLF [19].…”

Section: Discussionmentioning

confidence: 99%

Artificial Liver Support System Combined with Liver Transplantation in the Treatment of Patients with Acute-on-Chronic Liver Failure

Liu

Ling

et al. 2013

PLoS ONE

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BackgroundThe search for a strategy to provide temporary liver support and salvage the patients with acute-on-chronic liver failure (ACLF) remains an important issue. This study was designed to evaluate the experience in artificial liver support system (ALSS) combined with liver transplantation (LT) in the treatment of ACLF.Methodology/Principal FindingsOne hundred and seventy one patients with HBV related ACLF undergoing LT between January 2001 and December 2009 were included. Of the 171 patients, 115 received 247 sessions of plasma exchange-centered ALSS treatment prior to LT (ALSS-LT group) and the other 56 received emergency LT (LT group). The MELD score were 31±6 and 30±7 in ALSS-LT group and LT group. ALSS treatment resulted in improvement of liver function and better tolerance to LT. The average level of serum total bilirubin before LT was lower than that before the first time of ALSS treatment. The median waiting time for a donor liver was 12 days (2–226 days) from the first run of ALSS treatment to LT. Compared to LT group, the beneficial influences of ALSS on intraoperative blood loss and endotracheal intubation time were also observed in ALSS-LT group. The 1-year and 5-year survival rates in the ALSS-LT group and LT group were 79.2% and 83%, 69.7% and 78.6%.Conclusions/SignificancePlasma exchange-centered ALSS is beneficial in salvaging patients with ACLF when a donor liver is not available. The consequential LT is the fundamental treatment modality to rescue these patients and lead to a similar survival rate as those patients receiving emergency transplantation.

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Section: Discussionmentioning

confidence: 99%

Artificial Liver Support System Combined with Liver Transplantation in the Treatment of Patients with Acute-on-Chronic Liver Failure

Liu

Ling

et al. 2013

PLoS ONE

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“…The prognosis of ALF has improved in Japan with the increased frequency of LDLT and use of ALS therapy [1][2][3]28]. However, even in recent years, the survival rate in Japan for the subacute type was only 24.4% without LT compared with the acute type without LT (53.7%) [4].…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, other cases may possibly be treated without transplantation. The development of ALS in Japan and MARS in the U.S. and Europe has facilitated the maintenance of consciousness in ALF patients, even after they have experienced encephalopathy and brain edema [13,14,28]. ALS and MARS result in significant improvements in blood chemistry, coagulation parameters, and also the degree of HE, but there have been no reliable prognostic markers for evaluating whether such an outcome will be transient or sustained after stopping ALS or MARS.…”

Section: Discussionmentioning

confidence: 99%

A new prognostic formula for adult acute liver failure using computer tomography-derived hepatic volumetric analysis

et al. 2009

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“…Artificial Liver Support System (ALSS) has been used as a promising liver assistance system for years and has efficiently decreases the mortality of patients with severe hepatitis in the early and middle stages [11][12], as well as liver cirrhosis and liver failure [13][14]. For patients who developed massive necrosis of hepatocytes and lost ability of liver regeneration, several times of ALSS and sequential timely LT were needed [15].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E virus infection results in acute graft failure after liver transplantation: a case report

Liu

Shen

Wang

et al. 2014

J Infect Dev Ctries

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Hepatitis E virus (HEV) infection in most individuals is known as a self-limiting, acute, icteric hepatitis, but evidence shows HEV is responsible for choric hepatitis and rapid progressed liver cirrhosis in immuno-compromised patients. We present the case of a patient whose diagnosis of acute graft failure was due to a HEV infection 7 years after his first liver transplantation because of Wilson's disease. The process showed severe jaundice with fatigue, poor appetite and continually rising serum aminopherase. The blood serum was found positive for the anti-HEV IgG antibody but negative for anti-HEV IgM or other infections. Cholangiole cholestasis was detected in graft biopsy. Triple hepato-protective drugs (Transmetil, Polyene Phosphatidylcholine, and Compound Ammonium Glycyrrhetate S) alongside five times Artificial Liver Support System (ALSS) did not improve the patient's condition, but the total bilirubin level rose to more than 900umol/L. So re-transplantation was performed. Blood testing shows normal liver enzymes and bilirubin with persisting anti-HEV IgG antibody positive at the 3-month follow-up.

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Long‐Term Survivors with Artificial Liver Support in Fulminant Hepatic Failure

Abstract: Clinical ability of artificial liver support (ALS)

Cited by 15 publications

References 23 publications

Artificial Liver Support System Combined with Liver Transplantation in the Treatment of Patients with Acute-on-Chronic Liver Failure

Artificial Liver Support System Combined with Liver Transplantation in the Treatment of Patients with Acute-on-Chronic Liver Failure

A new prognostic formula for adult acute liver failure using computer tomography-derived hepatic volumetric analysis

Hepatitis E virus infection results in acute graft failure after liver transplantation: a case report

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