The Series‐parallel Circuit in the Treatment of Fulminant Hepatitis

Nakae, Hajime; Yonekawa, Chikara; Moon, Sunkwi; Tajimi, Kimitaka

doi:10.1111/j.1526-0968.2003.00125.x

Cited by 16 publications

(31 citation statements)

References 12 publications

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“…showed that the clearance of cytokines such as IL‐6 and IL‐8 was about 18 mL/min (24). The removal of bilirubin in PDF was 35.6%, and in a combination of PE and CHDF it was approximately 44% (4–6,25). The removal rate in PDF was lower than that in PE and CHDF.…”

Section: Discussionmentioning

confidence: 83%

Multicenter Study of Plasma Diafiltration in Patients With Acute Liver Failure

et al. 2010

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Plasma diafiltration (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside the hollow fibers. A prospective, multicenter study was undertaken to evaluate the changes in bilirubin, IL-18, and cystatin C, as well as the 28-day and 90-day survival rates, with the use of PDF according to the level of severity as measured by the Model for End-Stage Liver Disease (MELD) score. Twenty-one patients with liver failure were studied: 10 patients had fulminant hepatitis and PDF therapies were performed 28 times; 11 had acute liver failure with the therapy performed 96 times. Levels of total bilirubin, IL-18, and cystatin C decreased significantly after treatment. The 28-day survival rate was 70.0% and that at 90 days was 16.7%. According to the severity of the MELD score, each of the results compared well with the use of Molecular Adsorbent Recirculating System or Prometheus therapy. In conclusion, PDF appears to be one of the most useful blood purification therapies for use in cases of acute liver failure in terms of medical economics and the removal of water-soluble and albumin-bound toxins.

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Section: Discussionmentioning

confidence: 83%

Multicenter Study of Plasma Diafiltration in Patients With Acute Liver Failure

et al. 2010

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“…However, since PE is not selective, it not only removes toxins such as bilirubin, but also beneficial substances such as hepatocyte growth factor (24). Therefore, the usefulness of PE combined with CHDF treatment has been suggested (16). In the present case, our patient promptly responded to the combined PE and PMMA‐CHDF therapy.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Acute Renal Failure and Fulminant Hepatitis Associated With Edaravone Administration in a Cerebral Infarction Patient

2007

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A 60-year-old male with cerebral infarction was admitted to our hospital and treated with edaravone. On day 12 of hospitalization, he suddenly lost consciousness and went into shock. Based on the laboratory findings, acute renal failure (ARF), fulminant hepatitis, and disseminated intravascular coagulation (DIC) were diagnosed. We immediately initiated continuous hemodiafiltration for three days and performed three sessions of plasma exchange. Following this, a gradual improvement was observed in the patient's general condition and laboratory values. On day 17 of hospitalization, intermittent hemodialysis (HD) was initiated. On day 20 of hospitalization, his renal function started to improve with an increase in urine volume. HD was successfully discontinued on the same day. Although the drug lymphocyte stimulation test for edaravone was negative, edaravone-induced fulminant hepatitis was suggested based on liver biopsy findings. We present a case of ARF, fulminant hepatitis, and DIC due to edaravone administration that was successfully treated with blood purification techniques. Since the use of edaravone treatment is expected to increase in the future, it is essential that clinicians consider the potential adverse effects of this treatment. It is suggested that blood purification is effective in inducing remission in patients with complications due to edaravone treatment.

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“…There was no blood access difficulty such as catheter failure or coagulation in the filter during blood purification. We previously reported that even when the series‐parallel method was chosen for the combined PE and CHDF treatment, it was difficult to remove the excess citrate, which is contained in the anticoagulants in FFP, by our procedure of CHDF (1–3). The remaining amount of citrate might prevent clotting in the circuits.…”

Section: Discussionmentioning

confidence: 99%

The Dose of Nafamostat Mesilate During Plasma Exchange With Continuous Hemodiafiltration in the Series‐Parallel Circuit

2006

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We studied nafamostat mesilate (NM) and interleukin (IL)-18 levels to determine whether the dose of NM is reduced during plasma exchange (PE) with continuous hemodiafiltration (CHDF) when the series-parallel circuit is used. The subjects of the current study included four patients with acute hepatic failure who underwent PE with CHDF. The four patients underwent a total 15 PE + CHDF procedures, and for each procedure, they were randomized to receive either a half-dose of NM or no NM in the CHDF circuit. Eight procedures were carried out with NM administration, and seven were carried out without NM administration. The dose of NM in the NM group was significantly higher than that in the non-NM group (P = 0.040). No significant differences were observed between the two groups in the inlet NM concentration, the outlet NM concentration, or the rate of IL-18 removal. No statistical correlation was observed between the IL-18 level and the NM dose, the inlet NM concentration, or the outlet NM concentration. There was no blood access difficulty such as catheter failure or clotting of the filter. Thus, it might be possible to carry out PE and CHDF with the series-parallel method without administration of NM in the CHDF circuit.

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The Series‐parallel Circuit in the Treatment of Fulminant Hepatitis

Cited by 16 publications

References 12 publications

Multicenter Study of Plasma Diafiltration in Patients With Acute Liver Failure

Multicenter Study of Plasma Diafiltration in Patients With Acute Liver Failure

A Case Report of Acute Renal Failure and Fulminant Hepatitis Associated With Edaravone Administration in a Cerebral Infarction Patient

The Dose of Nafamostat Mesilate During Plasma Exchange With Continuous Hemodiafiltration in the Series‐Parallel Circuit

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