混合生物人工肝的早期临床经验。
Early clinical experience with a hybrid bioartificial liver.
作者信息
Demetriou A A, Rozga J, Podesta L, Lepage E, Morsiani E, Moscioni A D, Hoffman A, McGrath M, Kong L, Rosen H
机构信息
Liver Support Unit, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
出版信息
Scand J Gastroenterol Suppl. 1995;208:111-7. doi: 10.3109/00365529509107771.
BACKGROUND
Severe liver failure is associated with high mortality. Orthotopic liver transplantation (OLT) is the only effective therapeutic modality; there is a need for a 'bridge' system to support patients until an organ becomes available.
METHODS
A bioartificial liver (BAL) was used to treat 10 patients with severe liver failure. A plasmapheresis system was used to pump patient plasma through a module with porcine hepatocytes. Each treatment lasted 6-7 h.
RESULTS
All patients tolerated the procedure(s) well. Eight patients underwent OLT following BAL treatment(s). There were two late deaths after recovery from liver failure. Five patients with increased intracranial pressure (ICP) and decerebration had ICP normalization, increased cerebral perfusion pressure and full neurologic recovery after OLT. There was improvement in the level of encephalopathy and a significant decrease in serum ammonia after BAL treatment(s).
CONCLUSIONS
BAL treatment is safe and beneficial and can be successfully used as a 'bridge' to transplantation.
背景
严重肝衰竭与高死亡率相关。原位肝移植（OLT）是唯一有效的治疗方式；需要一种“桥梁”系统来支持患者直至获得可用器官。
方法
使用生物人工肝（BAL）治疗10例严重肝衰竭患者。采用血浆置换系统将患者血浆泵入装有猪肝细胞的模块。每次治疗持续6 - 7小时。
结果
所有患者对治疗耐受良好。8例患者在接受BAL治疗后接受了OLT。有2例患者在肝衰竭恢复后晚期死亡。5例颅内压（ICP）升高和去大脑强直的患者在OLT后ICP恢复正常，脑灌注压升高且神经功能完全恢复。BAL治疗后脑病程度有所改善，血清氨显著降低。
结论
BAL治疗安全有益，可成功用作移植的“桥梁”。
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