Application of Molecular Adsorbent Recirculating System® in patients with severe liver failure after hepatic resection or transplantation:: initial single-centre experiences
Application of Molecular Adsorbent Recirculating System® in patients with severe liver failure after hepatic resection or transplantation:: initial single-centre experiences
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DOI：
10.1034/j.1600-0676.2002.00011.x
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发表时间：
2002-04-01
期刊：
影响因子：
--
通讯作者：
Timmermann, W
中科院分区：
文献类型：
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作者：
Kellersmann, R;Gassel, HJ;Timmermann, W
肝手术后急性肝功能衰竭仍然是斑块性的，死亡率很高。最近，一种允许白蛋白结合物质解毒的肝透析系统（MARS(R)）已经开发出来，可能因此支持肝脏再生和患者康复。在本研究中，我们报告了我们在肝切除术或肝移植后肝功能衰竭患者中进行MARS(R)透析的经验。1999年9月至2001年1月间，5例患者接受MARS(R)治疗（2-5个疗程）。虽然在MARS(R)治疗期间记录了诸如脑病和肾功能改善以及胆红素水平降低等有益效果，但只有一名患者存活。使用MARS(R)透析未发生重大技术问题或不良反应。我们的结论是，在手术患者中，急性肝衰竭通常是影响多器官系统的复杂临床过程的一部分。因此，很难确定MARS(R)对患者预后的具体影响。然而，在我们的患者中观察到的有益效果证明了其继续使用的合理性，并可能刺激在外科患者的对照研究中进一步评估。
Acute liver failure after hepatic surgery is still plaqued with high mortality rate. Recently, a liver dialysis system (MARS(R)) that allows detoxification of albumin-bound substances and may hereby support liver regeneration and patient's recovery has been developed. In the present study, we report our experiences with MARS(R) dialysis in patients with liver failure after hepatic resection or transplantation. Between September 1999 and January 2001, five patients were treated with MARS(R) (2-5 courses). Though beneficial effects such as improvement of encephalopathy and renal function as well as reduced bilirubin levels were recorded during MARS(R) therapy, only one patient survived. Neither significant technical problems nor adverse effects occurred by using MARS(R) dialysis. We conclude that in surgical patients, acute liver failure is usually part of a complicated clinical course affecting multipleorgan systems. Thus, it is difficult to determine the specific influence of MARS(R) on patient's outcome. However, beneficial effects observed in our patients justify its continuous use and may stimulate further evaluation in controlled studies with surgical patients.