Karvellas Constantine J, Subramanian Ram M
Division of Hepatology, University of Alberta, Edmonton, Alberta, Canada; Division of Critical Care Medicine, University of Alberta, 1-40 Zeidler Ledcor Building, Edmonton, Alberta T6G-2X8, Canada.
Division of Hepatology, Emory University, Atlanta, GA, USA; Division of Critical Care Medicine, Emory University, Atlanta, GA, USA.
Crit Care Clin. 2016 Jul;32(3):439-51. doi: 10.1016/j.ccc.2016.03.003.
Artificial (nonbiological) extracorporeal liver support devices aim to remove albumin-bound and water-soluble toxins to restore and preserve hepatic function and mitigate or limit the progression of multiorgan failure while hepatic recovery or liver transplant occurs. The following beneficial effects have been documented: improvement of jaundice, amelioration of hemodynamic instability, reduction of portal hypertension, and improvement of hepatic encephalopathy. The only randomized prospective multicenter controlled trial to show an improvement in transplant-free survival was for high-volume plasmapheresis. Biological (cell-based) extracorporeal liver support systems aim to support the failing liver through detoxification and synthetic function and warrant further study for safety and benefit.
人工（非生物）体外肝支持装置旨在清除与白蛋白结合的和水溶性毒素，以恢复和维持肝功能，减轻或限制多器官功能衰竭的进展，同时等待肝脏恢复或进行肝移植。已证实有以下有益效果：黄疸改善、血流动力学不稳定状况改善、门静脉高压降低以及肝性脑病改善。唯一一项显示无移植生存期有所改善的随机前瞻性多中心对照试验是关于大容量血浆置换的。生物（基于细胞的）体外肝支持系统旨在通过解毒和合成功能来支持衰竭的肝脏，其安全性和益处有待进一步研究。
