Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study
Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study
复制标题
DOI：
10.1016/j.jhep.2015.03.018
复制
发表时间：
2015-08-01
影响因子：
25.7
通讯作者：
Li, Lanjuan
中科院分区：
文献类型：
--
作者：
Zhou, Ning;Li, Jianzhou;Li, Lanjuan
背景与目的：体外循环血液净化系统广泛应用于肝衰竭的支持治疗。我们开发了一种新型的血液净化系统，命名为李氏人工肝系统（Li-ALS），它耦合了低容量血浆置换（低容量PE）和血浆过滤吸附（PFA）。本研究旨在评估我们的新系统在急性肝功能衰竭（ALF）猪中的有效性。方法：32头猪输注D-氨基半乳糖（1.3 g/kg）诱导ALF。所有动物均随机分为4组：ALF对照组接受重症监护，PFA组接受5小时血浆循环过滤和吸附纯化，低容量PE组接受1小时低容量PE，Li-ALS组接受1小时低容量PE，随后接受5小时PFA。给药后36小时开始干预。通过生存时间以及血液学、生化和免疫组织学参数的改善来评估每种治疗的功效。结果：Li-ALS组的猪生存时间比其他组更长（p < 0.001，ALF对照：60 +/-2小时; PFA组：74 +/-2小时;低容量PE组：75 +/-2小时;和Li-ALS组：90 +/-3小时）。Li-ALS治疗后肝酶、胆红素、胆汁酸和血氨水平显著降低，炎性细胞因子的升高得到改善。Li-ALS组的肝细胞再生指数也较高。结论：我们的新型Li-ALS可以加速肝再生，提高生存时间，因此，它可能是有前途的治疗ALF。(C)2015年欧洲肝脏研究协会。由Elsevier B出版。V.保留所有权利。
Background & Aims: Extracorporeal blood purification systems for supportive therapy of liver failure are widely used. We developed a novel blood purification system, named Li's artificial liver system (Li-ALS), which couples low-volume plasma exchange (low-volume PE) with plasma filtration adsorption (PFA). This study aims to evaluate the efficacy of our novel system in pigs with acute liver failure (ALF).Methods: Thirty-two pigs were infused with D-galactosamine (1.3 g/kg) to induce ALF. All animals were equally and randomly divided into four groups: the ALF control group received intensive care, the PFA group underwent five hour plasma recycling filtration and adsorption purification, the low-volume PE group received one hour low-volume PE, and the Li-ALS group underwent one hour low-volume PE, followed by five hour PFA. Intervention was initiated 36 hours after drug administration. The efficacy of each treatment was assessed by survival time and improvement in hematological, biochemical, and immunohistological parameters.Results: Pigs in the Li-ALS group survived longer than those in the other groups (p < 0.001, ALF control: 60 +/- 2 h; PFA group: 74 +/- 2 h; low-volume PE group: 75 +/- 2 h; and Li-ALS group: 90 +/- 3 h). Liver enzyme, bilirubin, bile acid and blood ammonia levels were decreased significantly after Li-ALS treatment, and increases in inflammatory cytokines were ameliorated. A higher hepatocyte regeneration index was also observed in the Li-ALS group.Conclusion: Our novel Li-ALS could expedite liver regeneration and improve survival time; hence, it could be promising for treating ALF. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B. V. All rights reserved.