Conducted at the University of California, Los Angeles, this randomized, prospectively controlled study was designed to measure the effects of a hemodiabsorption device in the treatment of 11 patients with hepatic failure and stage III to IV encephalopathy. The results of 5 days of treatment with the hemodiabsorption device were compared with those of standard intensive care procedures. The BioLogic-DT System, a simple sorbent-based system, demonstrated a slight improvement in the neurologic status of patients, a significant improvement in the physiologic status of patients, and an improved outcome for treated patients as opposed to nontreated patients.
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References
1.
AshSR. Treatment of acute hepatic failure with encephalopathy: A review. Int J Artif Organs.1991;14:191–195.
2.
SchaferDFJonesEA. Hepatic encephalopathy. In: ZakimDBoyerTD, eds. Hepatology: A Textbook of Liver Disease.Philadelphia, Pa: WB Saunders Company; 1990;2:447–460.
3.
SherlockSA. In: SherlockS. Diseases of the Liver and Biliary System.7th ed.Oxford, England: Blackwell Scientific Publications; 1985:117–134.
4.
BonkovoskyHLNompleggiDJ. Enteral and parenteral nutritional supplementation in chronic liver disease.Chicago, Ill: AASLD course; 1992:271–292.
5.
WinchesterJF. Hemoperfusion. In: MasherJF, ed. Replacement of renal function by dialysis.Dordrecht, Holland: Kluwer Academic Publishers; 1989:439–459.
6.
O'GradyJGGimsonAESO'BrienCJPucknellAHughesRDWilliamsR. Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure. Gastroenterology.1988;94:1186–1192.
7.
HughesRDNagakiMKeaneHSheronNWilliamsR. Artificial liver support in acute liver failure: A review of studies at King's. Artif Organs.1992;16:167–170.
8.
PerezGOGolperTAEpsteinMOsterJ. Dialysis, hemofiltration, and other extracorporeal techniques in the treatment of the renal complications of liver disease. In: EpsteinM, ed. The Kidney in Liver Disease.4th Ed.Philadelphia, Pa: Hanley & Belfus Inc; 1996:517–528.
9.
MatsubaraS. Combination of plasma exchange and continuous hemofiltration as temporary metabolic support for patients with acute liver failure. Artif Organs.1994;18:342–347.
EllisAJWendonJHughesRSussmanNL. A controlled trial of the Hepatix extracorporeal liver assist device (ELAD) in acute liver failure. Hepatology.1994;20(4):140A.
12.
DemetriouAAWantanabeFRozgaJ. Artificial hepatic support systems. In: BoyerJLOcknerRK, eds. Progress in Liver Diseases.Philadelphia, Pa: WB Saunders Company; 1995;8:331–348.
13.
AshSRCarrDJBlakeDERainierJBDemetriouAARozgaJ. Effect of sorbent based dialytic therapy with the BioLogic-DT on an experimental model of hepatic failure. ASAIO J.1993;39:M657–M680.
14.
AshSRBlakeDECarrDJCarterCHowardTMakowkaL. Neurologic improvement of patients with hepatic failure and coma during sorbent suspension dialysis. ASAIO Trans.1991;37(3):M332–M334.
15.
AshSRBlakeDECarrDJ. Increasing selectivity of chemical removal from blood by preloading charcoal of the BioLogic-DT. Am Filtration Soc.1993;7:329–332.
16.
AshSRBlakeDECarrDJCarterCHowardTMakowkaL. Clinical effects of a sorbent suspension dialysis system in treatment of hepatic coma (the BioLogic-DT). Int J Artif Organs.1992;15:151–161.
17.
AshSRBlakeDECarrDJ. Increasing selectivity of chemical removal from blood by pre-loading charcoal of the BioLogic-DT. Am Filtration Soc.1993;7:329–332.
18.
CaronnaJJLeighJShawD. The outcome of medical coma: Prediction by bedside assessment of physical signs. Trans Am Neurol Assoc.1975;100:25.
19.
AshSR. Hemodiabsorption in the treatment of acute hepatic failure. ASAIO J.1994;40:80–82.
20.
HughesRDPucknellARoutleyDLangleyPGWendonJAWilliamsR. Evaluation of the BioLogic-DT sorbent-suspension dialyser in patients with fulminant hepatic failure. Int J Artif Organs.1994;17:657–662.
21.
O'GradyJGAlexanderGJMHayliarKMWilliamsR. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology.1989;97:439–445.
22.
TreyCDavidsonCS. The management of fulminant hepatic failure. In: PopperHSchaffnerF, eds. Progress in Liver Disease.New York, NY: Grune & Stratton; 1970:282–298.
23.
AshSRBlakeDECarrDJHarkerKD. Push-pull sorbent-based pheresis for treatment of acute hepatic failure: The BioLogic-DTPF. ASAIO J. In press.
