The Use Prometheus FPSA System in the Treatment of Acute Liver Failure: Preliminary Results

Skwarek, Anna; Grodzicki, Mariusz; Nyckowski, P; Kotulski, Marcin; Zieniewicz, Krzysztof; Michałowicz, B; Patkowski, Waldemar; Grzelak, I; Paczkowska, A; Giercuszkiewicz, Dorota; Sańko-Resmer, Joanna; Pączek, Leszek; Krawczyk, Marek

doi:10.1016/j.transproceed.2005.12.011

Cited by 52 publications

(34 citation statements)

References 14 publications

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“…amino acids [12], and ammonia [9], with conflicting results relating inflammation markers such as tumor necrosis factor-alpha [10,13,14], and interleukin-6 [10,14]. MARS was described in the improvement of hemodynamic parameters such as mean arterial pressure in 2 randomized, controlled studies, although no clinical outcome could be associated [7,15].…”

Section: Discussionmentioning

confidence: 99%

Liver Depurative Techniques: A Single Liver Transplantation Center Experience

Rodrigues

Castro

Moya

et al. 2015

Transplantation Proceedings

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Background. In a liver transplant (LT) center, treatments with Prometheus were evaluated. The main outcome considered was 1 and 6 months survival. Methods. During the study period, 74 patients underwent treatment with Prometheus; 64 were enrolled, with a mean age of 51 AE 13 years; 47 men underwent 212 treatments (mean, 3.02 per patient). The parameters evaluated were age, sex, laboratorial (liver enzymes, ammonia) and clinical (model for end-stage liver disease and Child-Turcotte-Pugh score) data. Results. Death was verified in 23 patients (35.9%) during the hospitalization period, 20 patients (31.3%) were submitted to liver transplantation, and 21 were discharged. LT was performed in 4 patients with acute liver failure (ALF, 23.7%), in 7 patients with acute on chronic liver failure (AoCLF, 43.7%), and in 6 patients with liver disease after LT (30%). Seven patients who underwent LT died (35%). In the multivariate analysis, older age (P ¼ .015), higher international normalized ratio (INR) (P ¼ .019), and acute liver failure (P ¼ .039) were independently associated with an adverse 1-month clinical outcome. On the other hand, older age (P ¼ .011) and acute kidney injury (P ¼ .031) at presentation were both related to worse 6-month outcome. For patients with ALF and AoCLF we did not observe the same differences. Conclusions. In this cohort, older age was the most important parameter defining 1-and 6-month survival, although higher INR and presence of ALF were important for 1-month survival and AKI for 6-month survival. No difference was observed between patients who underwent LT or did not have LT.

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Section: Discussionmentioning

confidence: 99%

Liver Depurative Techniques: A Single Liver Transplantation Center Experience

Rodrigues

Castro

Moya

et al. 2015

Transplantation Proceedings

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“…To date, the most widely used and studied methods of extracorporeal liver support are the MARS [21][22][23] , and Prometheus [24][25][26][27] systems. However, an additional method of extracorporeal support is the use of SPAD [28] .…”

Section: Discussionmentioning

confidence: 99%

“…Regrettably, there is an absolute paucity of clinical data evaluating extracorporeal liver support systems in AALF [25] . Moreover, no prospective studies to date have examined SPAD in ALF.…”

Section: Discussionmentioning

confidence: 99%

A Case-Control Study of Single-Pass Albumin Dialysis for Acetaminophen-Induced Acute Liver Failure

et al. 2009

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Background: Extracorporeal support with single-pass albumin dialysis (SPAD) may remove protein-bound toxins in acute liver failure. We evaluated the clinical, physiological and laboratory parameters of SPAD in acetaminophen-induced acute liver failure (AALF). Methods: Retrospective case-control studies of AALF patients were used. Results: We identified 13 AALF patients (6 SPAD-treated, 7 controls). The average age was 38 years, 92% were female, none had cirrhosis and the Model for End-Stage Liver Disease (MELD) scores were 43. Eleven patients (85%) fulfilled the King’s College criteria for a liver transplant. SPAD-treated patients received 21 sessions (total: 147 h, mean 3.5 runs or 24.5 h/patient). There were no complications. No significant changes in clinical, physiological or biochemical parameters occurred during SPAD. Compared with the controls, there were no significant differences in ICU or 1-year survival, liver recovery or referral for a liver transplant. Conclusion: SPAD was well-tolerated in AALF; however, it was not associated with differences in clinical outcomes. While SPAD may be an adjuvant supportive therapy in AALF, prospective trials are needed.

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“…Parece existir un comportamiento diferente de la PAM según el sistema de depuración hepática extracorpórea que se utilice, ya que en series de casos se observó que el sistema Prometheus s produce una disminución reversible de la PAM 26,28 . Se ha especulado que una posible causa podría ser el paso de la albúmina del paciente por el circuito secundario del sistema Prometheus s , lo que provocaría cambios en la presión osmótica por disminución de la albúmina sérica 17,29 .…”

Section: Cambios En Los Parámetros Hemodinámicos Y Bioquímicosunclassified

Evaluación de los sistemas de soporte hepático extracorpóreo en el tratamiento de la insuficiencia hepática. Revisión sistemática

Merino

2010

Gastroenterología y Hepatología

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The Use Prometheus FPSA System in the Treatment of Acute Liver Failure: Preliminary Results

Cited by 52 publications

References 14 publications

Liver Depurative Techniques: A Single Liver Transplantation Center Experience

Liver Depurative Techniques: A Single Liver Transplantation Center Experience

A Case-Control Study of Single-Pass Albumin Dialysis for Acetaminophen-Induced Acute Liver Failure

Evaluación de los sistemas de soporte hepático extracorpóreo en el tratamiento de la insuficiencia hepática. Revisión sistemática

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