【Abstract】Objective To evaluate effect of artificial liver support system (ALSS) in liver failure and liver transplantation.
Methods Forty-four patients with liver failure (including 12 undergoing liver transplantation) were treated with MARS or plasma exchange. The changes of toxic substances and cytokines in blood were detected before and after treatment.
Results ALSS therapy achieved a remarkable improvement in clinical symptoms and physical signs. After ALSS treatment, there was a significant decrease in total bilirubin, total bile acid, alanine aminotransferase, creatinine, urea nitrogen, blood ammonia and endotoxin levels(P＜0.05); the levels of serum NO, TNF-α, IL-4 and IL-6 were significantly decreased(P＜0.05); there was no statistical change in erythrocytes, leukocytes and platelets. The survival rate of 30 liver failure patients caused by severe hepatitis B was 60.0%(18/30). Six patients with acute liver failure were successfully performed liver transplantation. Two patients in 6 with acute liver failure after liver transplantation survived. One patient in 2 with acute liver failure after pancreatoduodenectomy survived.
Conclusion ALSS plays a positive role in treatment of liver failure by removing blood toxins, NO and cytokines. ALSS also plays a substitute role for liver failure patients who are waiting for liver transplantation.
Citation：
A Yongjun,LI Li,LI Xiaoyan,TANG Jihong,WEI Xiaoping,CHEN Gang,ZHU Hong.. Application of Artificial Liver Support System in Liver Failure and Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(5): 496-498. doi:
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- 1. Bathgate AJ, Garden OJ, Forsythe JR, et al. The outcome of the first 165 orthotopic liver transplants in Scotland [Ｊ]. Scott Med J, 1999; 44(1)∶ 9.
- 2. Stange J, Mitzner S, Klammt S, et al. New extracorporeal liver support for chronic liver disease complicated by cholestasisresults of a prospective controlled randomized two center trial [Ｊ]. J Hepatol, 2001; 34(Supple 1)∶45A1289.
- 3. Mitzner SR, Stange J, Klammt S, et al. Albumin dialysis using the molecular adsorbent recirculating system [Ｊ]. Curr Opin Nephrol Hypertens, 2001; 10(6)∶777.
- 4. 李兰娟，杨芊，黄建荣，等. 人工肝支持系统治疗重症肝炎的应用研究 [Ｊ]. 中华传染病杂志， 2001； 114（9）∶941.
- 5. 中华医学会传染病与寄生虫病学分会肝病学分会. 病毒性肝炎防治方案 [Ｊ]. 中华肝脏病杂志， 2000； 8（6）∶324.
- 6. Palmes D, Qayumi AK, Spiegel HU. Liver bridging techniques in the treatment of acute liver failure [Ｊ]. J Invest Surg, 2000; 13(6)∶299.
- 7. Sorkine P, Ben A braham R, Szold O, et al. Role of the molecular adsorbents recycling system(MARS) in the treatment of patients with acuteonchronic liver failure [Ｊ]. Liver Transplant, 2001; 7(2)∶1034.
- 8. Jalan R, Williams R. Acuteonchronic liver failure: pathophysiological basis of therapeutic options [Ｊ]. Blood Purif， 2002; 20(3)∶252.
- 9. Mitzner SR, Stange J, Klammt S, et al. Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure [Ｊ]. J Am Soc Nephrol, 2001; 12(Suppl 17)∶S75.
- 10. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsisrelated Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on SepsisRelated Problems of the European Society of Intensive Care Medicine [Ｊ]. Intensive Care Med, 1996; 22(7)∶707.
