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Large-pore hemodialytic procedures in pigs with ischemic hepatic necrosis; a randomized study
Hepato-Gastroenterology
|December 1, 1984
Summary
Hemodialytic procedures significantly extended survival in pigs with acute hepatic necrosis by slowing the development of hepatic encephalopathy. This treatment effectively reduced harmful toxins like ammonia and methionine, improving neurological function.
Area of Science:
- Hepatology
- Nephrology
- Critical Care Medicine
Background:
- Acute hepatic failure is a critical condition with high mortality.
- Ischemic hepatic necrosis can lead to multi-organ dysfunction and encephalopathy.
- The role of extracorporeal procedures in managing acute hepatic failure requires further definition.
Purpose of the Study:
- To investigate the therapeutic efficacy of hemodialytic procedures in a porcine model of ischemic hepatic necrosis.
- To compare the effects of hemodialysis and hemofiltration on survival and neurological function.
- To identify potential mechanisms by which extracorporeal procedures influence outcomes.
Main Methods:
- Twenty pigs with ischemic hepatic necrosis were randomized into four groups: hemodialysis, hemofiltration, control hemofiltration, and no extracorporeal procedure.
- Survival time, electroencephalogram (EEG) changes, and plasma levels of putative toxins (ammonia, glutamine, tyrosine, tryptophan, methionine) were monitored.
- Statistical analysis was performed to compare outcomes between groups and identify factors associated with long-term survival.
Main Results:
- Pigs undergoing hemodialytic procedures (hemodialysis and hemofiltration) survived significantly longer (51 ± 11 hrs) than controls (36 ± 8 hrs).
- Electroencephalograms showed slower deterioration in the treatment group compared to controls (p < 0.05).
- Plasma levels of ammonia and methionine were significantly lower in long-term survivors and were associated with improved EEG findings.
Conclusions:
- Hemodialytic procedures, including hemodialysis and hemofiltration, prolong survival in ischemic hepatic necrosis.
- These procedures appear to mitigate hepatic encephalopathy by reducing plasma ammonia and methionine levels.
- Extracorporeal therapies offer a potential therapeutic strategy for acute hepatic failure.
