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Updated: May 29, 2026

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Published on: December 18, 2013
The Prometheus device for extracorporeal support of combined liver and renal failure
Kinan Rifai1, Thomas Ernst, Ulrich Kretschmer
1Division of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hannover, Germany. rifai.k@gmx.de
Background/Aims:
Prometheus is a newly developed extracorporeal liver support system that combines removal of albumin-bound substances (adsorption on resin adsorbers) and water-soluble substances (diffusion during high-flux hemodialysis). Therefore, it is a promising treatment option for patients with hepatorenal syndrome (HRS).
Methods:
We studied 10 patients with HRS in a prospective clinical study. All patients underwent 2 consecutive Prometheus treatments. A variety of clinical and biochemical parameters were assessed.
Results:
Prometheus treatment was uncomplicated and safe. A statistically significant improvement of serum creatinine and urea concentrations as well as blood pH was observed after Prometheus treatment. Furthermore, liver detoxification was supported by a significant decrease of serum levels of conjugated bilirubin, bile acids and ammonia.
Conclusions:
Prometheus is a safe treatment for patients with HRS. Both, albumin-bound and water-soluble substances were effectively removed. Controlled studies will evaluate the effect of this new treatment option on survival in patients with HRS.
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