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Application of plasma perfusion in hepatic failure.
Summary
Plasma perfusion effectively removes bilirubin, ammonia, and amino acids in patients with hepatic failure, showing comparable efficiency to plasma exchange. Further clinical studies are needed for its application in liver assistance.
Area of Science:
- Hepatology
- Biomedical Engineering
- Clinical Medicine
Background:
- Hepatic failure poses significant challenges in patient management.
- Liver assistance systems aim to support liver function during critical illness.
- Plasma exchange is a current therapeutic option, but its efficacy and limitations are continually studied.
Purpose of the Study:
- To evaluate the efficacy of plasma perfusion as a liver-assistance system.
- To compare the performance of plasma perfusion with plasma exchange in removing toxins.
- To assess the potential of plasma perfusion for treating hepatic failure.
Main Methods:
- Seventeen patients with hepatic failure underwent 37 plasma perfusion sessions and 43 plasma exchange sessions.
- Plasma perfusion utilized the Plasma-flo AP-08-H separator and Bespore UPC-III or BR 350 adsorbers.
- Treated plasma volume averaged 5.0 L for perfusion and 2.1 L for exchange.
Main Results:
- Plasma perfusion removed 37% (Bespore) and 42% (BR) of bilirubin, compared to 29% with plasma exchange.
- Plasma ammonia levels decreased by 23% with perfusion versus 16% with exchange.
- Plasma perfusion improved the Fisher score (amino acid balance) from 1.8 to 2.4.
Conclusions:
- Plasma perfusion demonstrates comparable efficiency to plasma exchange in removing key toxins like bilirubin and ammonia.
- The procedure also shows promise in improving amino acid profiles, indicated by the Fisher score.
- Further clinical evaluation is necessary to establish plasma perfusion as a standard treatment for hepatic failure.