In Patients With End-Stage Liver Disease, Is Extra-Corporal Liver Support With Prometheus Safe?

Main Category: Liver Disease / Hepatitis
Also Included In: Transplants / Organ Donations;  Cardiovascular / Cardiology;  Clinical Trials / Drug Trials
Article Date: 22 May 2008 - 1:00 PDT

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Patients with end-stage liver disease would benefit from liver supportive liver therapy while waiting for stabilization of hepatic functions or to enable bridging to liver transplantation. Albumin dialysis improves patients' general condition, including cardiovascular and renal function as well as the degree of hepatic encephalopathy. Studies evaluating the hemodynamic alterations in stable patients with cirrhosis during extra-corporal intervention remain scarce, though such knowledge might evidently improve patient safety and perhaps lessen reluctance toward the early use of extra-corporal liver support.

The decision to use extra-corporal liver support in the treatment of patients with end-stage liver disease hinges on many factors, with safety considerations a major concern. The choice of treatment will depend on the risk of adverse events, and possible positive or negative hemodynamic influences between the available treatment modalities.

A research article published in the World Journal of Gastroenterology addresses these issues. In this clinical study, the authors aimed to determine the hemodynamic profile of intervention with Prometheus™, using MARS™ and hemodialysis as control groups, in patients with end-stage liver disease. They found the Prometheus system does not aggravate the systemic hemodynamics. However, Prometheus therapy does not exert an equally beneficial influence on arterial pressure as seen during MARS treatment. It was concluded that an intervention using extra-corporal liver support with albumin-dialysis should not be withheld merely because of safety considerations in the future.

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Reference: Dethloff T, Tofteng F, Frederiksen H-J, Hojskov M, Hansen BA, Larsen FS. Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: A randomized, controlled trial. World J Gastroenterol 2008; 14(13): 2065-2071 http://www.wjgnet.com/1007-9327/14/2065.asp

Correspondence to: Fin Stolze Larsen, Department of Hepatology, Section A-2121, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Jing Zhu
World Journal of Gastroenterology

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