Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease
Liver transplantation is the only effective treatment modality for end-stage liver disease. However, donor organs are not always available. In some cases, the gravity of the patient’s condition makes transplantation impossible. In this regard, the use of artificial liver support systems helps in pre...
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| Format: | Article |
| Language: | Russian |
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2020-10-01
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| Series: | Vestnik Transplantologii i Iskusstvennyh Organov |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/1225 |
| _version_ | 1797871969567244288 |
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| author | A. G. Strokov I. L. Poz A. R. Monakhov S. V. Meshcheryakov M. A. Voskanov S. V. Gautier |
| author_facet | A. G. Strokov I. L. Poz A. R. Monakhov S. V. Meshcheryakov M. A. Voskanov S. V. Gautier |
| author_sort | A. G. Strokov |
| collection | DOAJ |
| description | Liver transplantation is the only effective treatment modality for end-stage liver disease. However, donor organs are not always available. In some cases, the gravity of the patient’s condition makes transplantation impossible. In this regard, the use of artificial liver support systems helps in preparing a patient for transplant surgery. Objective: to conduct a retrospective study aimed at evaluating the efficiency of fractionated plasma separation and adsorption system. Materials and methods. From January 2019 to May 2020, 139 pediatric liver transplants were. We analyzed the data of 5 pediatric patients (2 girls and 3 boys, aged 12 to 17 years) who received fractionated plasma separation and adsorption (FPSA) sessions as a bridge to transplantation. The main clinical indication for FPSA was severe hepatic encephalopathy (grade 3 according to the West Haven Criteria), which was observed at 350–872 μmol/L (average 597 ± 98 μmol/L) serum bilirubin level. The FPSA sessions were conducted on a Prometheus device using AV-600 hemofilters as dialyzers (Fresenius Medical Care, Germany). Results. Depending on the extent of bilirubinemia in patients, it took from one (in one case) to three (in one case) daily FPSA sessions to restore clear consciousness, appetite and physical activity. Average bilirubin levels after treatment cycles decreased from 597 ± 98 to 236 ± 73 μmol/L. All patients successfully underwent liver transplant surgery within two to five days, two patients received a liver fragment from a living related donor. Conclusion. The FPSA system stabilizes the condition of potential recipients with acute liver failure. Further research is required to develop optimal regimens for albumin dialysis. |
| first_indexed | 2024-04-10T00:52:31Z |
| format | Article |
| id | doaj.art-f18a670c2e8e42cf97cda877a464f64c |
| institution | Directory Open Access Journal |
| issn | 1995-1191 |
| language | Russian |
| last_indexed | 2024-04-10T00:52:31Z |
| publishDate | 2020-10-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Vestnik Transplantologii i Iskusstvennyh Organov |
| spelling | doaj.art-f18a670c2e8e42cf97cda877a464f64c2023-03-13T10:37:26ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovVestnik Transplantologii i Iskusstvennyh Organov1995-11912020-10-01223364210.15825/1995-1191-2020-3-36-42893Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver diseaseA. G. Strokov0I. L. Poz1A. R. Monakhov2S. V. Meshcheryakov3M. A. Voskanov4S. V. Gautier5Shumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityLiver transplantation is the only effective treatment modality for end-stage liver disease. However, donor organs are not always available. In some cases, the gravity of the patient’s condition makes transplantation impossible. In this regard, the use of artificial liver support systems helps in preparing a patient for transplant surgery. Objective: to conduct a retrospective study aimed at evaluating the efficiency of fractionated plasma separation and adsorption system. Materials and methods. From January 2019 to May 2020, 139 pediatric liver transplants were. We analyzed the data of 5 pediatric patients (2 girls and 3 boys, aged 12 to 17 years) who received fractionated plasma separation and adsorption (FPSA) sessions as a bridge to transplantation. The main clinical indication for FPSA was severe hepatic encephalopathy (grade 3 according to the West Haven Criteria), which was observed at 350–872 μmol/L (average 597 ± 98 μmol/L) serum bilirubin level. The FPSA sessions were conducted on a Prometheus device using AV-600 hemofilters as dialyzers (Fresenius Medical Care, Germany). Results. Depending on the extent of bilirubinemia in patients, it took from one (in one case) to three (in one case) daily FPSA sessions to restore clear consciousness, appetite and physical activity. Average bilirubin levels after treatment cycles decreased from 597 ± 98 to 236 ± 73 μmol/L. All patients successfully underwent liver transplant surgery within two to five days, two patients received a liver fragment from a living related donor. Conclusion. The FPSA system stabilizes the condition of potential recipients with acute liver failure. Further research is required to develop optimal regimens for albumin dialysis.https://journal.transpl.ru/vtio/article/view/1225cirrhosisliver failurealbumin dialysisliver transplantationpediatric liver transplantationextracorporeal liver supporthepatic encephalopathyfractionated plasma separation and adsorption |
| spellingShingle | A. G. Strokov I. L. Poz A. R. Monakhov S. V. Meshcheryakov M. A. Voskanov S. V. Gautier Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease Vestnik Transplantologii i Iskusstvennyh Organov cirrhosis liver failure albumin dialysis liver transplantation pediatric liver transplantation extracorporeal liver support hepatic encephalopathy fractionated plasma separation and adsorption |
| title | Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease |
| title_full | Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease |
| title_fullStr | Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease |
| title_full_unstemmed | Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease |
| title_short | Efficacy of albumin dialysis as a bridge to transplantation in children with end-stage liver disease |
| title_sort | efficacy of albumin dialysis as a bridge to transplantation in children with end stage liver disease |
| topic | cirrhosis liver failure albumin dialysis liver transplantation pediatric liver transplantation extracorporeal liver support hepatic encephalopathy fractionated plasma separation and adsorption |
| url | https://journal.transpl.ru/vtio/article/view/1225 |
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