2015Kazan medical journalOpen access

The study of albumin dialysis efficiency in acute liver failure using the «Bioartificial liver» device

Е.Е. Polevshchikova

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Abstract

Aim. Clinical testing of albumin dialysis method in patients with acute liver failure of different etiologies on the experimental sample of the «bioartificial liver» device. Methods. Clinical assessment of treatment using the «bioartificial liver» device was conducted on 20 patients aged 22-68 years old who had acute liver failure of different etiology. The «bioartificial liver» device consisted of a perfusion unit, the dialyzer, dialysis circuit with albumin solution and carbon haemosorbent mode. A 10% donor human albumin solution was used as the dialysis fluid in recirculation mode. For restoration of the accepting ability albumin was exposed to perfusion through the carbonic hemosorbent. Duration of the treatment was 3 hours, control of liver damage biochemical markers was performed before and after the session. Results. There was a statistically significant reduction in biochemical markers of cytolysis and cholestasis: transaminases, alkaline phosphatase and bilirubin levels. We also observed a statistically significant reduction of ammonia level, which is one of the main clinical and laboratory signs characterizing the severity of encephalopathy. Improvement of liver synthetic function reflected a statistically significant increase in glucose level. Clinical stabilization as well as reduction of encephalopathy clinical signs were observed after the procedure. No side effects were notices. Conclusion. Implementation of albumin dialysis in patients with acute liver failure using the «bioartificial liver» device was accompanied by an improvement of their functional state. This gives reason to use this method for the treatment of acute liver failure in intensive care units.

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Aim. Clinical testing of albumin dialysis method in patients with acute liver failure of different etiologies on the experimental sample of the «bioartificial liver» device. Methods. Clinical assessment of treatment using the «bioartificial liver» device was conducted on 20 patients aged 22-68 years old who had acute liver failure of different etiology. The «bioartificial liver» device consisted of a perfusion unit, the dialyzer, dialysis circuit with albumin solution and carbon haemosorbent mode. A 10% donor human albumin solution was used as the dialysis fluid in recirculation mode. For restoration of the accepting ability albumin was exposed to perfusion through the carbonic hemosorbent. Duration of the treatment was 3 hours, control of liver damage biochemical markers was performed before and after the session. Results. There was a statistically significant reduction in biochemical markers of cytolysis and cholestasis: transaminases, alkaline phosphatase and bilirubin levels. We also observed a statistically significant reduction of ammonia level, which is one of the main clinical and laboratory signs characterizing the severity of encephalopathy. Improvement of liver synthetic function reflected a statistically significant increase in glucose level. Clinical stabilization as well as reduction of encephalopathy clinical signs were observed after the procedure. No side effects were notices. Conclusion. Implementation of albumin dialysis in patients with acute liver failure using the «bioartificial liver» device was accompanied by an improvement of their functional state. This gives reason to use this method for the treatment of acute liver failure in intensive care units.

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Available abstract

Aim. Clinical testing of albumin dialysis method in patients with acute liver failure of different etiologies on the experimental sample of the «bioartificial liver» device. Methods. Clinical assessment of treatment using the «bioartificial liver» device was conducted on 20 patients aged 22-68 years old who had acute liver failure of different etiology. The «bioartificial liver» device consisted of a perfusion unit, the dialyzer, dialysis circuit with albumin solution and carbon haemosorbent mode. A 10% donor human albumin solution was used as the dialysis fluid in recirculation mode. For restoration of the accepting ability albumin was exposed to perfusion through the carbonic hemosorbent. Duration of the treatment was 3 hours, control of liver damage biochemical markers was performed before and after the session. Results. There was a statistically significant reduction in biochemical markers of cytolysis and cholestasis: transaminases, alkaline phosphatase and bilirubin levels. We also observed a statistically significant reduction of ammonia level, which is one of the main clinical and laboratory signs characterizing the severity of encephalopathy. Improvement of liver synthetic function reflected a statistically significant increase in glucose level. Clinical stabilization as well as reduction of encephalopathy clinical signs were observed after the procedure. No side effects were notices. Conclusion. Implementation of albumin dialysis in patients with acute liver failure using the «bioartificial liver» device was accompanied by an improvement of their functional state. This gives reason to use this method for the treatment of acute liver failure in intensive care units.

Key concepts: Bioartificial liver device, Liver failure, Albumin, Dialysis, Medicine, Artificial liver, Hemofiltration, Internal medicine

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