| Albumin dialysis reduces portal pressure acutely in patients with severe alcoholic hepatitis. | |
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MedLine Citation:
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PMID: 15878216 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: In patients with alcoholic hepatitis (AH), inflammation contributes to the severity of portal hypertension. This study evaluates the acute effects of albumin dialysis, using the Molecular Adsorbents Recirculating System (MARS), on portal pressure in AH. METHODS: Eleven patients with AH and portal hypertension were treated with MARS (n=8) or haemofiltration (n=3). All patients had associated organ failure manifested by hepatic encephalopathy (Grade 2 or more) or renal failure. Hepatic venous pressure gradient (HVPG) was measured before, during and after the treatment session. RESULTS: A rapid significant reduction of HVPG was observed by 6 h (falling by > or =20% in 7/8 patients, reaching 12 mmHg in 6/8), which was sustained up to 18 h after stopping dialysis. Similar rapid sustained improvements of systemic haemodynamics were also observed. No changes occurred in three patients receiving haemofiltration alone. CONCLUSIONS: Albumin dialysis produces clinically significant, acute reduction in portal pressure but the mechanism by which this effect is achieved is not clear. Our results suggest that MARS may be a useful adjunct in management of portal hypertension, particularly in patients with severe AH with associated organ failure. |
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Authors:
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Sambit Sen; Rajeshwar P Mookerjee; Lisa M Cheshire; Nathan A Davies; Roger Williams; Rajiv Jalan |
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Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2005-04-09 |
Journal Detail:
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Title: Journal of hepatology Volume: 43 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-14 Completed Date: 2005-12-29 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 142-8 Citation Subset: IM |
Affiliation:
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Liver Failure Group, Institute of Hepatology, University College London Medical School, 69-75 Chenies Mews, London WC1E 6HX, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Albumins* Blood Pressure* Cardiovascular System / physiopathology Female Hemodynamics Hemofiltration Hepatic Encephalopathy / etiology, therapy Hepatic Veins / physiopathology Hepatitis, Alcoholic / complications*, physiopathology Humans Hypertension, Portal / etiology*, physiopathology, therapy* Kidney Failure / etiology, therapy Liver Circulation Male Middle Aged Portal System / physiopathology* Renal Dialysis / methods* Severity of Illness Index Time Factors Treatment Outcome Venous Pressure |
| Chemical | |
Reg. No./Substance:
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0/Albumins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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