Department of Hepatology, University Hospital Gasthuisberg, UZ Gasthuisberg, KU Leuven, Leuven, Belgium.
Best Pract Res Clin Gastroenterol. 2012 Feb;26(1):17-26. doi: 10.1016/j.bpg.2012.01.002.
Non-biological artificial liver support (ALS) devices aim to remove albumin-bound and water-soluble toxins arising as a result of liver failure. They do not directly improve the liver synthetic capacity. The currently most used devices combine haemodialysis with albumin dialysis (MARS) or plasma separation and filtration (Prometheus). These devices have been used as a treatment for different types of liver failure: acute liver failure, acute-on-chronic liver failure and primary non- or poor-function after liver transplantation. Overall these devices are found to be safe. The following beneficial effects have been documented: improvement of jaundice, amelioration of haemodynamic instability, reduction of portal hypertension, lowering of intracranial pressure and improvement of hepatic encephalopathy. However, recently multicentre controlled trials failed to show a beneficial effect on transplant-free survival. Therefore the use of these devices at present seems only justified as a bridge to liver transplantation.
非生物型人工肝支持（ALS）设备旨在清除肝功能衰竭时产生的结合白蛋白和水溶性的毒素。它们并不能直接改善肝脏的合成能力。目前最常用的设备是将血液透析与白蛋白透析（MARS）或血浆分离和过滤（Prometheus）相结合。这些设备已被用于治疗不同类型的肝衰竭：急性肝衰竭、慢加急性肝衰竭和肝移植后原发性无功能或功能不良。总体而言，这些设备被认为是安全的。已经记录到以下有益效果：黄疸改善、血流动力学不稳定的缓解、门静脉高压降低、颅内压降低和肝性脑病改善。然而，最近的多中心对照试验未能显示对无肝移植生存的有益影响。因此，目前使用这些设备似乎只是作为肝移植的桥梁是合理的。
