Document Detail


Changes in plasma amino acids during extracorporeal liver support by fractionated plasma separation and adsorption.
MedLine Citation:
PMID:  19817727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In patients with liver failure, amino acid dysbalance is common and associated with hepatic encephalopathy. Prometheus is a newly designed extracorporeal liver support system based upon fractionated plasma separation and adsorption (FPSA). We evaluated the influence of FPSA on plasma amino acid patterns in patients with liver failure and hepatic encephalopathy. We studied nine patients with acute-on-chronic liver failure, hepatic encephalopathy, and concomitant renal failure. A single session of FPSA therapy for 5 +/- 1 h was performed in all patients. Twenty-six different plasma amino acids were measured by high-performance liquid chromatography before and after FPSA treatment. Total amino acids as well as Fischer index were calculated. Additionally, a variety of clinical and biochemical parameters were assessed. Before FPSA was started, plasma levels of most amino acids were elevated. Plasma ammonia levels correlated with glutamine levels (P < 0.04). During FPSA, plasma levels of nearly all amino acids significantly decreased except for branched-chain amino acids. The Fischer index improved without reaching statistical significance. FPSA therapy tends to normalize plasma amino acids in patients with combined liver and renal failure. This may contribute to positive pathophysiologic effects, especially on hepatic encephalopathy. However, the clinical significance of these findings needs to be further evaluated.
Authors:
Kinan Rifai; Anibh Das; Jens Rosenau; Thomas Ernst; Ulrich Kretschmer; Hermann Haller; Danilo Fliser; Michael Peter Manns
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Publication Detail:
Type:  Journal Article     Date:  2009-10-10
Journal Detail:
Title:  Artificial organs     Volume:  34     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  166-70     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. rifai.k@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Amino Acids / blood*
Ammonia / blood
Chromatography, High Pressure Liquid
Extracorporeal Circulation*
Female
Hepatic Encephalopathy / blood*,  complications,  surgery
Humans
Kidney Failure / blood,  complications,  surgery
Liver Failure / blood*,  complications,  surgery
Male
Middle Aged
Serum Albumin
Sorption Detoxification / methods
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Serum Albumin; 7664-41-7/Ammonia

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


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