Efficient removal of serum bilirubin by a novel artificial liver support system using albumin convection: a pilot study

Blood Purif. 2012;34(3-4):201-8. doi: 10.1159/000342111.

Abstract

Background/aims: To compare the efficacy of a new artificial liver support system, fractionated plasma separation and adsorption integrated with hemofiltration, with the old system, plasma adsorption.

Methods: Sixteen patients with acute liver failure each received a first session of treatment using the old system, in which plasma was perfused through an adsorber. They then received a second session using the new system, in which albumin-rich plasma separated using a fraction plasma separator was ultrafiltrated using a hemofilter and perfused through an adsorber before being returned to blood.

Results: The new system had a higher clearance of bilirubin and slower decline of clearance over time. There was a lower reduction ratio of bilirubin, bile acid, urea, and creatinine; longer prolongation of coagulation parameters; and greater decline in albumin level using the old system compared with the new one.

Conclusions: Use of the novel system results in more efficient removal of toxins and fewer deterious effects than the old system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bilirubin / blood*
  • Convection*
  • Female
  • Humans
  • Liver Failure, Acute / blood
  • Liver Failure, Acute / metabolism
  • Liver Failure, Acute / therapy
  • Liver, Artificial*
  • Male
  • Middle Aged
  • Pilot Projects
  • Serum Albumin / metabolism*
  • Treatment Outcome

Substances

  • Serum Albumin
  • Bilirubin