Document Detail


Prometheus versus molecular adsorbents recirculating system: comparison of efficiency in two different liver detoxification devices.
MedLine Citation:
PMID:  16643386     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Albumin dialysis by the molecular adsorbents recirculating system (MARS) and by fractionated plasma separation, adsorption, and dialysis (Prometheus[PROM]) represent novel nonbiological liver support systems specifically designed to remove albumin-bound substances. Preliminary evidence suggests a favorable impact of MARS on the course and outcome of liver failure. This study aimed at comparing the detoxification capacity of both devices. For this purpose, we performed a retrospective analysis on data prospectively collected in patients with acute-on-chronic liver failure treated with either the MARS (n = 9) or the PROM (n = 9) device on 2-5 consecutive days. Each treatment was performed for at least 5 h at identical blood and dialysate flows. Blood clearances were calculated during the first treatment session for urea nitrogen, creatinine, total bilirubin, and bile acids from paired arterial and venous line samples after 1, 4, and 6 h of treatment. Reduction ratios for all single-treatment sessions, and the overall treatment phase, were calculated from pretreatment and post-treatment values. For all markers but bile acids, the single-treatment as well as the overall treatment phase reduction ratios obtained with PROM were significantly higher compared with those obtained with MARS. PROM led at all time points to higher clearances for all evaluated solutes. Blood clearances of protein-bound substances declined over time with MARS, but not with PROM. In conclusion, a significant decline in the serum level of water-soluble and protein-bound toxins was achieved with both devices. PROM produces higher blood clearances for most toxins, which results in higher delivered treatment doses compared with a matching treatment with MARS.
Authors:
Pieter Evenepoel; Wim Laleman; Alexander Wilmer; Kathleen Claes; Dirk Kuypers; Bert Bammens; Frederik Nevens; Yves Vanrenterghem
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  30     ISSN:  0160-564X     ISO Abbreviation:  Artif Organs     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-28     Completed Date:  2006-10-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  276-84     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Nephrology, University Hospital Leuven, Leuven, Belgium. pieter.evenepoel@uz.kuleuven.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ammonia / blood
Bile Acids and Salts / blood
Bilirubin / blood
Blood Urea Nitrogen
Creatinine / blood
Female
Humans
Liver Failure / blood,  therapy*
Male
Middle Aged
Prospective Studies
Retrospective Studies
Serum Albumin / analysis
Sorption Detoxification / instrumentation,  methods*
Chemical
Reg. No./Substance:
0/Bile Acids and Salts; 0/Serum Albumin; 60-27-5/Creatinine; 635-65-4/Bilirubin; 7664-41-7/Ammonia

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


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