| Is it possible to gain extra waiting time to liver transplantation in acute liver failure patients using albumin dialysis? | |
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MedLine Citation:
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PMID: 19788458 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hepatic encephalopathy (HE)-associated brain edema is a common cause of death in acute liver failure (ALF). Molecular Adsorbent Recirculating System (MARS) albumin dialysis detoxifies endogenous and exogenous toxins from blood and improves HE. In this study we assessed the effect of MARS on increasing the length of time available while waiting for liver graft. Thirty-seven patients with ALF who received a high-urgent liver transplant (LTx) were divided into three groups according to the amount of histological necrosis in the explanted liver: group I = 100% necrosis; group II = 80-99% necrosis; group III = less than 80% necrosis. MARS was used continuously until LTx. Median time (range) on MARS treatment prior to LTx in groups I-III was 7 days (2-26), 6 days (1-17), and 5 days (1-15), and the median time on the waiting list was 5 days (1-11), 3 days (0-13), and 1 day (0-12), respectively. The HE grade prior to and after MARS was similar in all groups. In two patients the HE grade decreased during MARS treatment, even though the explanted liver showed a complete lack of viable cells. Overall 30-day and one-year survival were 97% and 92%, respectively, without differences between the three groups. In ALF patients the liver cell damage progressed to total or near total necrosis of the liver when the waiting time was prolonged. Yet, with MARS treatment some patients with total hepatic necrosis showed an absence of encephalopathy. With MARS treatment some patients might be able to wait longer for a LTx with good results. |
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Authors:
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Anna-Maria Koivusalo; Taru Kantola; Johanna Arola; Krister H?ckerstedt; Pekka Kairaluoma; Helena Isoniemi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy Volume: 13 ISSN: 1744-9987 ISO Abbreviation: Ther Apher Dial Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-30 Completed Date: 2009-12-29 Revised Date: 2010-02-23 |
Medline Journal Info:
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Nlm Unique ID: 101181252 Medline TA: Ther Apher Dial Country: Australia |
Other Details:
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Languages: eng Pagination: 413-8 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Intensive Care Medicine, Surgical Hospital of Helsinki, Helsinki University Hospital, Helsinki, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Albumins / administration & dosage* Dialysis / methods* Disease Progression Hepatic Encephalopathy / etiology, mortality Humans Liver Failure, Acute / complications, mortality, therapy* Liver Transplantation* Middle Aged Necrosis / physiopathology Prospective Studies Survival Rate Time Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Albumins |
| Comments/Corrections | |
Erratum In:
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Ther Apher Dial. 2009 Dec;13(6):556 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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