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Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry
Klementina Ocskay1, Dana Tomescu2, Andreas Faltlhauser3
1Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.
Insights
Hemoadsorption therapy significantly reduced bilirubin levels in patients with liver dysfunction. This registry data highlights its potential impact on liver disease management and warrants further investigation.
Area of Science:
- Critical Care Medicine
- Hepatology
- Medical Technology
Background:
- The CytoSorb International Registry collects data on extracorporeal cytokine adsorber use.
- This analysis focuses on the 'liver indication' subset of patients.
Purpose of the Study:
- To report outcomes of hemoadsorption in patients treated for hyperbilirubinemia.
- To evaluate the effectiveness of hemoadsorption in liver dysfunction.
Main Methods:
- Structured data from the registry were analyzed.
- Treatment characteristics and clinical changes (bilirubin, inflammatory markers, SOFA scores, mortality) were assessed.
- Physician subjective assessments were included.
Main Results:
- 109 patients with hyperbilirubinemia received hemoadsorption.
- Significant reduction in serum bilirubin levels was observed (-4.6 mg/dL).
- 91% of patients were alive at treatment termination, with physician-observed improvement in 75 cases.
Conclusions:
- This is the largest case series on hemoadsorption for liver indications.
- Significant bilirubin removal suggests potential for hemoadsorption in managing liver dysfunction.
- Further studies are warranted to explore hemoadsorption's role in liver disease.
Background:
Our aim is to report the results of the 'liver indication' subset of patients in the CytoSorb International Registry.
Methods:
Structured data were recorded. Treatment characteristics and changes from T1 (start of hemoadsorption) to T2 (termination) were evaluated with a special focus on bilirubin, C-reactive protein, procalcitonin, interleukin-6, platelet levels, SOFA scores, mortality, and subjective assessment by the attending physicians.
Results:
Until January 2021, from the total 1434 patients, 109 (age: 49.2 ± 17.1 years, 57.8% males) received treatment for hyperbilirubinemia. APACHE II-predicted mortality was 49.6 ± 26.8%. In the study, 91% of patients were alive at the termination of hemoadsorption and improvement was observed by the physicians in 75 cases. Overall, 65 (59.6%) patients died in the hospital, and 60 (55.0%) died in the ICU. Patients received a median of two treatments for a median of 43 h (interquartile range: 24-72 h) in total. Serum bilirubin levels reduced significantly to -4.6 (95% CI: -6.329 to -2.8) mg/dL. Thrombocytopenia was reported in four patients as an adverse event.
Conclusions:
We report the largest case series on hemoadsorption for 'liver indication' from the CytoSorb International Registry. The finding of significant bilirubin removal observed in our study could have substantial impact in designing and executing further studies on the effects of hemoadsorption in liver dysfunction, which are certainly warranted.
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