A pilot study of using pure albumin as a dialysate in the treatment of liver failure
[Article in Chinese]
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2005 Oct;17(10):599-602
Liu Q, Peng L, Du Y, Li M, Jia N, Zou HQ.
The Center of Blood Purification, The Fifth Affiliated Hospital of Zhongshan University, Zhuhai 519000, Guangdong, China.
OBJECTIVE: To observe the effect of a new extracorporeal hepatic support-hemodialysis with albumin-based dialysate on patient with liver failure, and to compare the result with that of molecular absorbent recycling system (MARS).
METHODS: Eighteen patients with liver failure were enrolled and treated intermittently with artificial liver on the basis of conventional regime. Among them, 12 of them were treated with single albumin dialysis (SAD) for 6 hours each period, and 6 with MARS for 6 hours. During each session of SAD, 4 000 ml albumin-based dialysate (45 g/L) was circulated in the dialysate route at a flow rate of 10 L/h with the blood flow rate of 250 ml/min. Liver and renal function, prothrombin activity (PTA), serum ammonia (NH(3)), endotoxin were monitored before and after the treatment, and the serial bilirubin content was measured in the serum and the albumin dialysate of all patients respectively 1-hour, 3-hour, 6-hour after the treatment with SAD. RESULTS: After treatment with SAD, the clinical symptoms and signs were improved and the hemodynamics were stabilized, complications were ameliorated partially, in particular hepatic encephalopathy was improved, with low incidence of adverse reaction, and the effective rate and survival rate were high. The serum PTA was increased obviously (P<0.05), and the serum blood urea nitrogen (BUN), serum creatinine (SCr), total bilirubin (TB), total bile acid (TBA), NH(3), endotoxin were decreased significantly (all P<0.05), and elimination of bilirubin slowed down gradually. The results showed that SAD was as effective as MARS, with a lower cost, and simpler and more convenient than MARS. CONCLUSION: Single albumin dialysis may eliminate protein-bound and water-soluble hepatic toxins, improve clinical symptoms and liver function in the treatment of liver failure, and worth further clinical study.