A liver transplant center experience with liver dialysis in the management of patients with fulminant hepatic failure

A preliminary report

M. Aladaǧ, A. Gürakar, S. Jalil, H. Wright, S. Alamian, S. Rashwan, A. Sebastian, Bakr Nour

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Among extracorporeal liver support devices, liver dialysis is cleared by the U.S. Food and Drug Administration to be used for the management of fulminant hepatic failure (FHF). The outcomes of patients following liver dialysis need to be clearly evaluated. Among the 25 patients with FHF admitted to the Liver ICU between May 2000 and November 2002, 12 underwent liver dialysis, including 6 men and 6 women, of mean age 32 years. The causes of FHF were identified as acetaminophen (n = 10), herbal medications (n = 1) and autoimmune disease (n = 1). At presentation, the mean total bilirubin was 9.35 mg/dL (range, 0 to 1.3), mean ALT 3015 U/L (range, 0 to 48), mean AST 3457 (range, 0 to 42), mean ammonia 98 μmol/L (range, 10 to 60) and mean INR 1.88. A control group including 13 patients (2 men and 11 women), of mean age 27.8 years mean total bilirubin 5.66, mean ALT 3494, mean AST 3528, mean ammonia 113 and mean INR 3, were not treated with liver dialysis, due to the lack of machine availability or physician's choice. The causes of FHF were acute hepatitis B (n = 1), acetaminophen (n = 10) or unknown (n = 2). There was no statistically significant difference in the baseline characteristics of the two groups (P > .05). Among the liver dialysis group, 1 patient died, 2 underwent OLTx, and 9 were discharged home. Among the control group; 4 patients died, 2 underwent OLTx, and 7 were discharged home. Preliminary results seem to support survival benefit among patients who underwent liver dialysis compared to non-liver dialysis; however, further randomized control trials are warranted to verify this observation.

Original languageEnglish
Pages (from-to)203-205
Number of pages3
JournalTransplantation Proceedings
Volume36
Issue number1
DOIs
Publication statusPublished - Jan 2004
Externally publishedYes

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Acute Liver Failure
Dialysis
Transplants
Liver
International Normalized Ratio
Acetaminophen
Bilirubin
Ammonia
Control Groups
United States Food and Drug Administration
Hepatitis B
Autoimmune Diseases
Physicians
Equipment and Supplies
Survival

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

A liver transplant center experience with liver dialysis in the management of patients with fulminant hepatic failure : A preliminary report. / Aladaǧ, M.; Gürakar, A.; Jalil, S.; Wright, H.; Alamian, S.; Rashwan, S.; Sebastian, A.; Nour, Bakr.

In: Transplantation Proceedings, Vol. 36, No. 1, 01.2004, p. 203-205.

Research output: Contribution to journalArticle

Aladaǧ, M. ; Gürakar, A. ; Jalil, S. ; Wright, H. ; Alamian, S. ; Rashwan, S. ; Sebastian, A. ; Nour, Bakr. / A liver transplant center experience with liver dialysis in the management of patients with fulminant hepatic failure : A preliminary report. In: Transplantation Proceedings. 2004 ; Vol. 36, No. 1. pp. 203-205.
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