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Plasma separation for artificial liver support

E B LePage1, R Lane, D McKay

  • 1Liver Support Unit, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Journal of Clinical Apheresis
|January 1, 1995
PubMed
Summary
This summary is machine-generated.

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This study shows that bioartificial liver (BAL) support systems can safely process large blood volumes for extended periods in acute liver failure patients. Management strategies effectively controlled side effects like hypocalcemia.

Area of Science:

  • Biomedical Engineering
  • Hepatology
  • Critical Care Medicine

Background:

  • Acute liver failure (ALF) presents a critical unmet medical need.
  • Bioartificial Liver (BAL) support systems offer a potential therapeutic avenue.
  • Plasma separation is a key component in BAL technology.

Purpose of the Study:

  • To evaluate the safety and feasibility of extended, high-volume plasma separation using a BAL system in ALF patients.
  • To report methods for managing plasma separation and associated physiological parameters.

Main Methods:

  • Conducted 14 BAL treatments in nine severe ALF patients.
  • Utilized plasma separation for a mean duration of 435 minutes, processing 26-59 liters of blood per treatment.
  • Monitored key physiological and biochemical parameters, including ionized calcium, fibrinogen, and vital signs.

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Main Results:

  • BAL treatments were safely achieved for extended durations without serious adverse effects.
  • Significant decrease in ionized calcium (P < .02) and plasma fibrinogen (P < .002) observed.
  • Ionized hypocalcemia was effectively managed with calcium chloride, adjusted separation rates, and blood-to-citrate ratio modification.

Conclusions:

  • Intensive, large-volume plasma separation via BAL is feasible and safe in critically ill ALF patients.
  • Effective management strategies can mitigate treatment-related side effects like hypocalcemia.
  • BAL technology shows promise for supporting patients with acute liver failure.