Publication:
Evaluation of the Hepa Wash® treatment in pigs with acute liver failure

cris.virtual.author-orcid0000-0002-6819-6092
cris.virtualsource.author-orcid3ec0027b-2673-414b-8349-5980812773b3
dc.contributor.authorAl-Chalabi, Ahmed
dc.contributor.authorMatevossian, Edouard
dc.contributor.authorv. Thaden, Anne-K.
dc.contributor.authorLuppa, Peter
dc.contributor.authorNeiss, Albrecht
dc.contributor.authorSchuster, Tibor
dc.contributor.authorYang, Zejian
dc.contributor.authorSchreiber, Catherine
dc.contributor.authorSchimmel, Patrick
dc.contributor.authorNairz, Ewald
dc.contributor.authorRadermacher, Peter
dc.contributor.authorHuber, Wolfgang
dc.contributor.authorSchmid, Roland M.
dc.contributor.authorKreymann, Bernhard
dc.contributor.authorPerren, Aurel
dc.date.accessioned2024-10-15T05:41:49Z
dc.date.available2024-10-15T05:41:49Z
dc.date.issued2013
dc.description.abstractBACKGROUND Mortality of patients with acute liver failure (ALF) is still unacceptably high. Available liver support systems are still of limited success at improving survival. A new type of albumin dialysis, the Hepa Wash® system, was newly introduced. We evaluated the new liver support system as well as the Molecular Adsorbent Recycling System (MARS) in an ischemic porcine model of ALF. METHODS In the first study animals were randomly allocated to control (n=5) and Hepa Wash (n=6) groups. In a further pilot study, two animals were treated with the MARS-system. All animals received the same medical and surgical procedures. An intraparenchymal intracranial pressure was inserted. Hemodynamic monitoring and goal-directed fluid therapy using the PiCCO system was done. Animals underwent functional end-to-side portacaval shunt and ligation of hepatic arteries. Treatment with albumin dialysis was started after fall of cerebral perfusion pressure to 45 mmHg and continued for 8 h. RESULTS All animals in the Hepa Wash group survived the 13-hour observation period, except for one that died after stopping treatment. Four of the control animals died within this period (p=0.03). Hepa Wash significantly reduced impairment of cerebral perfusion pressure (23±2 vs. 10±3 mmHg, p=0.006) and mean arterial pressure (37±1 vs. 24±2 mmHg, p=0.006) but had no effect on intracranial pressure (14±1 vs. 15±1 mmHg, p=0.72). Hepa Wash also enhanced cardiac index (4.94±0.32 vs. 3.36±0.25 l/min/m2, p=0.006) and renal function (urine production, 1850 ± 570 vs. 420 ± 180 ml, p=0.045) and eliminated water soluble (creatinine, 1.3±0.2 vs. 3.2±0.3 mg/dl, p=0.01; ammonia 562±124 vs. 1382±92 μg/dl, p=0.006) and protein-bound toxins (nitrate/nitrite 5.54±1.57 vs. 49.82±13.27 μmol/l, p=0.01). No adverse events that could be attributed to the Hepa Wash treatment were observed. CONCLUSIONS Hepa Wash was a safe procedure and improved multiorgan system failure in pigs with ALF. The survival benefit could be the result of ameliorating different organ functions in association with the detoxification capacity of water soluble and protein-bound toxins.
dc.description.sponsorshipInstitut für Pathologie
dc.identifier.doi10.7892/boris.45144
dc.identifier.pmid23668774
dc.identifier.publisherDOI10.1186/1471-230X-13-83
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/117112
dc.language.isoen
dc.publisherBioMed Central
dc.relation.ispartofBMC gastroenterology
dc.relation.issn1471-230X
dc.relation.organizationDCD5A442BF89E17DE0405C82790C4DE2
dc.subjectArtificial liver
dc.subjectAcute liver failure
dc.subjectAlbumin dialysis
dc.subjectAnimal model
dc.subjectSwine
dc.subjectRenal dialysis
dc.subjectMultiple organ failure
dc.subjectCapillary leak syndrome
dc.subjectCardiovascular failure
dc.subjectRenal failure
dc.subject.ddc500 - Science::570 - Life sciences; biology
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleEvaluation of the Hepa Wash® treatment in pigs with acute liver failure
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.startPage83
oaire.citation.volume13
oairecerif.author.affiliationInstitut für Pathologie
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unibe.description.ispublishedpub
unibe.eprints.legacyId45144
unibe.journal.abbrevTitleBMC GASTROENTEROL
unibe.refereedTRUE
unibe.subtype.articlejournal

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