PMID: 11927902Apr 3, 2002Paper

Extracorporeal blood detoxification by sorbents in treatment of hepatic encephalopathy

Advances in Renal Replacement Therapy
Stephen R Ash

Abstract

Extracorporeal blood detoxification by sorbent therapy long has been applied in treatment of hepatic failure and encephalopathy, starting with hemoperfusion columns and more recently with the currently marketed Liver Dialysis Unit. Liver Dialysis employs hemodiabsorption (dialysis of blood against powdered sorbents including charcoal and cation exchanger) to remove selectively numerous small-molecular-weight toxins of hepatic failure. Liver Dialysis is used in treatment of acute hepatic encephalopathy (AHE) because of decompensation of chronic liver disease (A-on-C) or fulminant hepatic failure (FHF). Controlled, prospective and randomized studies of daily 6-hour Liver Dialysis have shown physiologic and neurologic improvement of patients with AHE, regardless of etiology. Liver dialysis significantly improved the incidence of positive outcomes (recovery of hepatic function or improvement for transplant) of A-on-C patients versus controls (71.5% treated, and 35.7% control, P =.036), but had an insignificant improvement in outcome of patients with FHF as compared with the control group. Other extracorporeal sorbent devices are now in clinical testing phase. The molecular adsorbent regenerating system (MARS) device employs a polys...Continue Reading

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Citations

Feb 9, 2013·Current Gastroenterology Reports·Rafael BañaresJavier Vaquero
Jan 28, 2005·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Stephen R AshT A Sullivan
Sep 9, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Pierre TissièresDenis Devictor
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Feb 20, 2016·Expert Review of Medical Devices·Jonathan AronAndrew Davenport
May 11, 2006·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Stephen R AshDavid J Carr
May 11, 2006·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Robert A F M ChamuleauMaarten-Paul van de Kerkhove
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Nov 27, 2007·Expert Review of Medical Devices·Benoît Carpentier, Stephen R Ash

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