A comparison among three different apheretic techniques for treatment of hyperbilirubinemia
Liver failure is associated to high mortality due to the accumulation of protein-bound metabolites, such as bilirubin, not removed by conventional hemodialysis. Different methods can efficiently remove them, such as the molecular adsorbent recirculating system (MARS), plasma exchange (PEX), and bilirubin or plasma adsorption perfusion (PAP). No direct comparison exists between MARS, PEX and PAP, and current guidelines do not specify which method (and when) to use. We have retrospectively evaluated MARS, PEX and PAP in their effectiveness in lowering plasma bilirubin concentration, and their effects on liver and kidney function. A total of 98 patients have been recruited, which comprised 68 patients treated with PAP (177 sessions), 16 patients with PEX (41 sessions) and 11 patients with MARS (21 sessions). Bilirubin, creatinine, liver enzymes were analyzed before and after the first treatment with each technique. The three methods did not differ for bilirubin lowering efficiency, with MARS showing only slightly less effective reductions. Finally, the three techniques did not differ in the amount of change of cholinesterase, but a lower reduction in AST was found using PAP. Our retrospective observation is one of the largest case series of hepatic failure treated with bilirubin absorption. The choice of the technique cannot be based on the desired reduction in bilirubin concentration. Based on costs and duration of treatment, we suggest that PAP could be considered as a first-line approach. In case of kidney involvement, MARS remains a valuable option.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
|---|---|
| Enthalten in: |
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs - 21(2018), 1 vom: 08. März, Seite 110-116 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Viggiano, Davide [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 27.07.2018 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s10047-017-0986-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM275590801 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM275590801 | ||
| 003 | DE-627 | ||
| 005 | 20231225010025.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10047-017-0986-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0918.xml |
| 035 | |a (DE-627)NLM275590801 | ||
| 035 | |a (NLM)28887736 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Viggiano, Davide |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A comparison among three different apheretic techniques for treatment of hyperbilirubinemia |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.07.2018 | ||
| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Liver failure is associated to high mortality due to the accumulation of protein-bound metabolites, such as bilirubin, not removed by conventional hemodialysis. Different methods can efficiently remove them, such as the molecular adsorbent recirculating system (MARS), plasma exchange (PEX), and bilirubin or plasma adsorption perfusion (PAP). No direct comparison exists between MARS, PEX and PAP, and current guidelines do not specify which method (and when) to use. We have retrospectively evaluated MARS, PEX and PAP in their effectiveness in lowering plasma bilirubin concentration, and their effects on liver and kidney function. A total of 98 patients have been recruited, which comprised 68 patients treated with PAP (177 sessions), 16 patients with PEX (41 sessions) and 11 patients with MARS (21 sessions). Bilirubin, creatinine, liver enzymes were analyzed before and after the first treatment with each technique. The three methods did not differ for bilirubin lowering efficiency, with MARS showing only slightly less effective reductions. Finally, the three techniques did not differ in the amount of change of cholinesterase, but a lower reduction in AST was found using PAP. Our retrospective observation is one of the largest case series of hepatic failure treated with bilirubin absorption. The choice of the technique cannot be based on the desired reduction in bilirubin concentration. Based on costs and duration of treatment, we suggest that PAP could be considered as a first-line approach. In case of kidney involvement, MARS remains a valuable option | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bilirubin adsorption | |
| 650 | 4 | |a Hyperbilirubinemia | |
| 650 | 4 | |a Liver failure | |
| 650 | 4 | |a Molecular adsorbent recirculating system | |
| 650 | 4 | |a Plasma adsorption perfusion | |
| 650 | 4 | |a Plasma exchange | |
| 650 | 7 | |a Creatinine |2 NLM | |
| 650 | 7 | |a AYI8EX34EU |2 NLM | |
| 650 | 7 | |a Bilirubin |2 NLM | |
| 650 | 7 | |a RFM9X3LJ49 |2 NLM | |
| 700 | 1 | |a de Pascale, Emanuela |e verfasserin |4 aut | |
| 700 | 1 | |a Marinelli, Gaia |e verfasserin |4 aut | |
| 700 | 1 | |a Pluvio, Corrado |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs |d 1997 |g 21(2018), 1 vom: 08. März, Seite 110-116 |w (DE-627)NLM097535141 |x 1619-0904 |7 nnns |
| 773 | 1 | 8 | |g volume:21 |g year:2018 |g number:1 |g day:08 |g month:03 |g pages:110-116 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s10047-017-0986-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 21 |j 2018 |e 1 |b 08 |c 03 |h 110-116 | ||