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Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure
Acute liver failure (ALF) and acute on chronic liver failure (AoCLF) carry a high mortality. The rationale for extracorporeal systems is to provide an environment facilitating recovery or a window of opportunity for liver transplantation. Recent technologies have used albumin as a scavenging molecul...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2007
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206413/ https://www.ncbi.nlm.nih.gov/pubmed/17567927 http://dx.doi.org/10.1186/cc5922 |
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author | Karvellas, Constantine J Gibney, Noel Kutsogiannis, Demetrios Wendon, Julia Bain, Vincent G |
author_facet | Karvellas, Constantine J Gibney, Noel Kutsogiannis, Demetrios Wendon, Julia Bain, Vincent G |
author_sort | Karvellas, Constantine J |
collection | PubMed |
description | Acute liver failure (ALF) and acute on chronic liver failure (AoCLF) carry a high mortality. The rationale for extracorporeal systems is to provide an environment facilitating recovery or a window of opportunity for liver transplantation. Recent technologies have used albumin as a scavenging molecule. Two different albumin dialysis systems have been developed using this principle: MARS (Molecular Adsorbent Recirculation System) and SPAD (Single-Pass Albumin Dialysis). A third system, Prometheus (Fractionated Plasma Separation and Adsorption), differs from the others in that the patient's albumin is separated across a membrane and then is run over adsorptive columns. Although several trials have been published (particularly with MARS), currently there is a lack of controlled studies with homogenous patient populations. Many studies have combined patients with ALF and AoCLF. Others have included patients with different etiologies. Although MARS and Prometheus have shown biochemical improvements in AoCLF and ALF, additional studies are required to show conclusive benefit in short- and long-term survival. The appropriate comparator is standard medical therapy rather than head-to-head comparisons of different forms of albumin dialysis. |
format | Text |
id | pubmed-2206413 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-22064132008-01-19 Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure Karvellas, Constantine J Gibney, Noel Kutsogiannis, Demetrios Wendon, Julia Bain, Vincent G Crit Care Review Acute liver failure (ALF) and acute on chronic liver failure (AoCLF) carry a high mortality. The rationale for extracorporeal systems is to provide an environment facilitating recovery or a window of opportunity for liver transplantation. Recent technologies have used albumin as a scavenging molecule. Two different albumin dialysis systems have been developed using this principle: MARS (Molecular Adsorbent Recirculation System) and SPAD (Single-Pass Albumin Dialysis). A third system, Prometheus (Fractionated Plasma Separation and Adsorption), differs from the others in that the patient's albumin is separated across a membrane and then is run over adsorptive columns. Although several trials have been published (particularly with MARS), currently there is a lack of controlled studies with homogenous patient populations. Many studies have combined patients with ALF and AoCLF. Others have included patients with different etiologies. Although MARS and Prometheus have shown biochemical improvements in AoCLF and ALF, additional studies are required to show conclusive benefit in short- and long-term survival. The appropriate comparator is standard medical therapy rather than head-to-head comparisons of different forms of albumin dialysis. BioMed Central 2007 2007-06-08 /pmc/articles/PMC2206413/ /pubmed/17567927 http://dx.doi.org/10.1186/cc5922 Text en Copyright © 2007 BioMed Central Ltd |
spellingShingle | Review Karvellas, Constantine J Gibney, Noel Kutsogiannis, Demetrios Wendon, Julia Bain, Vincent G Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title | Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title_full | Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title_fullStr | Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title_full_unstemmed | Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title_short | Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure |
title_sort | bench-to-bedside review: current evidence for extracorporeal albumin dialysis systems in liver failure |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206413/ https://www.ncbi.nlm.nih.gov/pubmed/17567927 http://dx.doi.org/10.1186/cc5922 |
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