Artificial liver support systems: what is new over the last decade?
Open Access
- 15 November 2018
- journal article
- review article
- Published by Springer Science and Business Media LLC in Annals of Intensive Care
- Vol. 8 (1), 1-14
- https://doi.org/10.1186/s13613-018-0453-z
Abstract
The liver is a complex organ that performs vital functions of synthesis, heat production, detoxification and regulation; its failure carries a highly critical risk. At the end of the last century, some artificial liver devices began to develop with the aim of being used as supportive therapy until liver transplantation (bridge-to-transplant) or liver regeneration (bridge-to-recovery). The well-recognized devices are the Molecular Adsorbent Recirculating System™ (MARS™), the Single-Pass Albumin Dialysis system and the Fractionated Plasma Separation and Adsorption system (Prometheus™). In the following years, experimental works and early clinical applications were reported, and to date, many thousands of patients have already been treated with these devices. The ability of artificial liver support systems to replace the liver detoxification function, at least partially, has been proven, and the correction of various biochemical parameters has been demonstrated. However, the complex tasks of regulation and synthesis must be addressed through the use of bioartificial systems, which still face several developmental problems and very high production costs. Moreover, clinical data on improved survival are conflicting. This paper reviews the progress achieved and new data published on artificial liver support systems over the past decade and the prospects for these devices.Keywords
This publication has 95 references indexed in Scilit:
- Artificial and bioartificial liver support systems for acute and acute-on-chronic hepatic failure: A meta-analysis and meta-regressionExperimental and Therapeutic Medicine, 2013
- Evaluation of the Hepa Wash®treatment in pigs with acute liver failureBMC Gastroenterology, 2013
- The effect of the molecular adsorbent recirculating system on moxifloxacin and meropenem plasma levelsActa Anaesthesiologica Scandinavica, 2012
- A prospective randomized open-label crossover trial of regional citrate anticoagulation vs. anticoagulation free liver dialysis by the Molecular Adsorbents Recirculating SystemCritical Care, 2012
- Proteomic Analysis of Polypeptides Captured from Blood during Extracorporeal Albumin Dialysis in Patients with Cholestasis and Resistant PruritusPLOS ONE, 2011
- Multicenter Study of Plasma Diafiltration in Patients With Acute Liver FailureTherapeutic Apheresis and Dialysis, 2010
- Role of Cytokines in the Pathophysiology of Acute-on-Chronic Liver FailureBlood Purification, 2009
- Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failureCritical Care, 2007
- Albumin dialysis in cirrhosis with superimposed acute liver injury: A prospective, controlled studyJournal of Hepatology, 2002
- Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Controlled Clinical Trials, 1996