• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Artificial Organs >Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: Depurative efficiency and clinical results in a long-term follow-up
【24h】

Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: Depurative efficiency and clinical results in a long-term follow-up

机译：使用分子吸附剂再循环系统进行肝衰竭的体外排毒：长期随访的净化效率和临床结果

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Acute liver failure and acute-on-chronic liver failure still show a poor prognosis. The molecular adsorbent recirculating system (MARS) has been extensively used as the most promising detoxifying therapy for patients with these conditions. Sixty-four patients with life-threatening liver failure were selected, and 269 MARS treatments were carried out as a bridge for orthotopic liver transplantation (OLT) or for liver function recovery. All patients were grouped according to the aim of MARS therapy. Group A consisted of 47 patients treated for liver function recovery (median age 59 years, range 23-82). Group B consisted of 11 patients on the waiting list who underwent OLT (median age 47 years, range 32-62). Group C consisted of 6 patients on the waiting list who did not undergo OLT (median age 45.5 years, range 36-54, P=0.001). MARS depurative efficiency in terms of liver toxins, cytokines, and growth factors was assessed together with the clinical outcome of the patients during a 1-year follow-up. Total bilirubin reduction rate per session (RRs) for each MARS session was 23% (range 17-29); direct bilirubin RRs was 28% (21-35), and indirect bilirubin RRs was 8% (3-21). Ammonia RRs was 34% (12-86). Conjugated cholic acid RRs was 58% (48-61); chenodeoxycholic acid RRs was 34% (18-48). No differences were found between groups. Hepatocyte growth factor (HGF) values on starting MARS were 4.1ng/mL (1.9-7.9) versus 7.9ng/mL (3.2-14.1) at MARS end (P<0.01). Cox regression analysis to determine the risk factors predicting patient outcomes showed that age, male gender, and Sequential Organ Failure Assessment score (but not Model for End-stage Liver Disease score) were factors predicting death, whereas the number of MARS sessions and the ΔHGF proved protective factors. Kaplan-Meier survival analysis was also used; after 12 months, 21.3% of patients in Group A survived, while 90.9% were alive in Group B and 16.7% in Group C (log rank=0.002). In conclusion, MARS was clinically well tolerated by all patients and significantly reduced hepatic toxins. Better survival rates were linked to an OLT program, but patients' clinical characteristics on starting MARS therapy were the main factors predicting survival. The role of HGF should be evaluated in larger clinical trials.
机译：急性肝衰竭和慢性慢性肝衰竭的预后仍然较差。分子吸附剂再循环系统（MARS）已被广泛用作患有这些疾病的患者最有希望的排毒疗法。选择了64例危及生命的肝衰竭患者，并进行了269种MARS治疗，以作为原位肝移植（OLT）或恢复肝功能的桥梁。根据MARS治疗的目的将所有患者分组。 A组由47例接受肝功能恢复治疗的患者组成（中位年龄59岁，范围23-82）。 B组由等待名单上的11例接受OLT（中位年龄47岁，范围32-62）的患者组成。 C组由6名未接受OLT的患者组成（中位年龄45.5岁，范围36-54，P = 0.001）。在1年的随访中，评估了MARS在肝毒素，细胞因子和生长因子方面的净化效率以及患者的临床结局。每次MARS疗程的每次疗程总胆红素减少率（RRs）为23％（范围17-29）;直接胆红素RRs为28％（21-35），间接胆红素RRs为8％（3-21）。氨的RRs为34％（12-86）。共轭胆酸RRs为58％（48-61）;鹅去氧胆酸的RRs为34％（18-48）。两组之间未发现差异。起始MARS的肝细胞生长因子（HGF）值为4.1ng / mL（1.9-7.9），而MARS末期为7.9ng / mL（3.2-14.1）（P <0.01）。用Cox回归分析确定可预测患者预后的危险因素，结果表明年龄，男性和顺序器官衰竭评估评分（而非末期肝病模型评分）是预测死亡的因素，而MARS疗程数和ΔHGF事实证明是保护因素。还使用了Kaplan-Meier生存分析。 12个月后，A组中21.3％的患者存活，而B组中90.9％存活，C组中16.7％（log rank = 0.002）。总之，所有患者在临床上对MARS的耐受性良好，并且肝毒素显着减少。更好的生存率与OLT计划有关，但是开始MARS治疗时患者的临床特征是预测生存率的主要因素。 HGF的作用应在较大的临床试验中进行评估。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号