Document Detail


Albumin dialysis reduces portal pressure acutely in patients with severe alcoholic hepatitis.
MedLine Citation:
PMID:  15878216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sambit Sen; Rajeshwar P Mookerjee; Lisa M Cheshire; Nathan A Davies; Roger Williams; Rajiv Jalan
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-04-09
Journal Detail:
Title:  Journal of hepatology     Volume:  43     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-14     Completed Date:  2005-12-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  142-8     Citation Subset:  IM    
Affiliation:
Liver Failure Group, Institute of Hepatology, University College London Medical School, 69-75 Chenies Mews, London WC1E 6HX, UK.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Albumins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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