EARLY CLINICAL-EXPERIENCE WITH A HYBRID BIOARTIFICIAL LIVER
EARLY CLINICAL-EXPERIENCE WITH A HYBRID BIOARTIFICIAL LIVER
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DOI：
10.3109/00365529509107771
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发表时间：
1995-01-01
影响因子：
1.9
通讯作者：
MAKOWKA, L
中科院分区：
文献类型：
--
作者：
DEMETRIOU, AA;ROZGA, J;MAKOWKA, L
背景：严重肝衰竭与高死亡率相关。原位肝移植（奥尔特）是唯一有效的治疗方式，需要一个“桥梁”系统来支持患者，直到器官可用。方法：应用生物人工肝（BAL）治疗10例重度肝衰竭患者。使用血浆置换系统将患者血浆泵送通过含猪肝细胞的模块。每次处理持续6-7 h。结果：所有患者对手术耐受良好。8例患者在BAL治疗后接受奥尔特。有2例在肝功能衰竭恢复后晚期死亡。5例颅内压升高和去脑患者术后颅内压恢复正常，脑灌注压升高，神经功能完全恢复。BAL治疗后脑病水平改善，血氨显著降低。结论：BAL治疗是安全和有益的，可以成功地用作移植的“桥梁”。
Background: Severe liver failure is associated with high mortality. Orthotopic liver transplantation (OLT) is the only effective therapeutic modality there is a need for a 'bridge' system to support patients until an organ becomes available. Methods: A bioartificial liver (BAL) was used to treat 10 patients with severe liver failure. A plasmapheresis system was used to pump patient plasma through a module with porcine hepatocytes. Each treatment lasted 6-7 h. Results: All patients tolerated the procedures(s) well. Eight patients underwent OLT following BAL treatment(s). There were two late deaths after recovery from liver failure. Five patients with increased intracranial pressure (ICP) and decerebration had ICP normalization, increased cerebral perfusion pressure and full neurologic recovery after OLT. There was improvement in the level of encephalopathy and a significant decrease in serum ammonia after BAL treatment(s). Conclusions: BAL treatment is safe and beneficial and can be successfully used as a 'bridge' to transplantation.