Neuzil D F, Rozga J, Moscioni A D, Ro M S, Hakim R, Arnaout W S, Demetriou A A
Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tenn.
Surgery. 1993 Mar;113(3):340-3.
We have developed a bioartificial liver support system (BAL) using porcine hepatocytes attached to microcarriers and placed on the outer surface of hollow fibers. The BAL system was attached to a plasmapheresis device that was then used to treat the plasma of a patient with acute liver failure. Our aim was to test the efficacy and safety of this system after a single short treatment period. A patient with alcohol-induced, severe, acute liver failure manifested by coagulopathy, rising plasma ammonia level, and deteriorating mental status was studied. The procedure was well tolerated by the patient, who remained hemodynamically stable throughout the treatment period. A marked increase in coagulation factor V, VII, VIII, and IX activities, a decrease in serum ammonia level (120 to 32 mumol/L), a twofold increase in all serum amino acids except for aminobutyric acid, and an improvement in mental status were noted after a 6-hour treatment period. This preliminary report of the first use of this novel BAL system in conjunction with plasmapheresis appears promising. A clinical study is now in progress to prove its efficacy.
我们研发了一种生物人工肝支持系统（BAL），该系统利用附着在微载体上的猪肝细胞，并将其置于中空纤维的外表面。BAL系统连接到一个血浆置换装置上，然后用于治疗急性肝衰竭患者的血浆。我们的目的是在单次短期治疗后测试该系统的疗效和安全性。研究了一名因酒精导致严重急性肝衰竭的患者，其表现为凝血功能障碍、血浆氨水平升高和精神状态恶化。该患者对该治疗过程耐受性良好，在整个治疗期间血流动力学保持稳定。在6小时的治疗期后，观察到凝血因子V、VII、VIII和IX活性显著增加，血清氨水平降低（从120降至32微摩尔/升），除氨基丁酸外所有血清氨基酸增加两倍，且精神状态有所改善。这份关于首次将这种新型BAL系统与血浆置换联合使用的初步报告似乎很有前景。目前正在进行一项临床研究以证明其疗效。
