Temporary Support for Acute Liver Failure
作者:
Pankaj Rajvanshi,
Anne Larson,
Kris Kowdley,
期刊:
Journal of Clinical Gastroenterology
(OVID Available online 2002)
卷期:
Volume 35,
issue 4
页码: 335-344
ISSN:0192-0790
年代: 2002
出版商: OVID
关键词: Acute liver failure;Liver assist device;Liver support;Bioartificial liver;Fulminant hepatic failure
数据来源: OVID
摘要:
GoalTo review treatment approaches for temporary liver support of patients with acute liver failure (ALF).StudyA MEDLINE search of English language reports published between 1960 and 1999 and a manual search of bibliographies of relevant papers were performed. Studies of humans in whom non-orthotopic liver transplant (OLT)-based approaches were used were reviewed, including case reports, case series, review articles describing unpublished cases, and controlled trials. Relevant clinical information was extracted with emphasis on improvement in liver function, successful bridging to OLT, recovery without OLT, and death. There was a lack of more than one controlled trial for each therapy, and most case reports were anecdotal in nature; therefore, no statistical analysis was attempted. Predefined outcomes from individual patients were synthesized collectively into tables.ResultsBoth cell-based and non-cell-based therapies for ALF appear promising. Preliminary experience has established the safety of these approaches, but current data are inadequate to evaluate efficacy.ConclusionsRoutine use of artificial liver support systems cannot be recommended at this time. However, the established safety of cell- and non-cell-based liver support devices warrants additional prospective (Phase III) controlled trials among patients with ALF. We suggest an algorithm for management of patients with ALF that incorporates recent data.
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