中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 35 Issue 9
Sep.  2019
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2019  >  35(9): 1909-1915

Non-bioartificial liver in liver failure: Clinical application and research advances

DOI: 10.3969/j.issn.1001-5256.2019.09.004

  • Department of Hemodialysis, Center for Urology, Beijing YouAn Hospital, Capital Medical University

Research funding:

 

  • Received Date: 2019-06-03
  • Published Date: 2019-09-20
    Abstract
  • Artificial liver is one of the most important methods for the treatment of liver failure. At present, there are many types of non-bioartificial liver used in clinical practice, with different mechanisms and indications, and the severity of the disease varies greatly among patients. Therefore, an individualized treatment regimen should be developed based on patients' conditions, features of each type of artificial liver, and actual situation. This article introduces the non-bioartificial liver systems commonly used in clinical practice, discusses their therapeutic effects, and elaborates on how to choose the appropriate artificial liver according to the clinical manifestations of patients with liver failure, in order to provide a reference for clinicians.

     

    • FullText(HTML)
  • loading
    • References(60)
  • [1] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure (2018) [J]. J Clin Hepatol, 2019, 35 (1) :38-44. (in Chinese) 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南 (2018年版) [J].临床肝胆病杂志, 2019, 35 (1) :38-44.
    [2] Liver Failure and Artificial Liver Group, Branch of Infectious Diseases, Chinese Medical Association. Guideline for nonbioartificial liver support systems in treatment of liver failure:2016 update[J]. Chin J Clin Infect Dis, 2016, 9 (2) :97-103. (in Chinese) 中华医学会感染病学分会肝衰竭与人工肝学组.非生物型人工肝治疗肝衰竭指南 (2016年版) [J].中华临床感染病杂志, 2016, 9 (2) :97-103.
    [3] LI S, CHEN Y. Coping with shortage of plasma-The new therapeutic pattern of non-bioartificial liver[J]. J Clin Hepatol, 2017, 33 (9) :1687-1692. (in Chinese) 李爽, 陈煜.血浆紧缺情况下非生物型人工肝治疗新模式的探讨[J].临床肝胆病杂志, 2017, 33 (9) :1687-1692.
    [4] CHUN YW, YING Z, MENG QY. Serum metabonomics analysis of liver failure treated by nonbioartificial liver support systems[J]. Can J Gastroenterol Hepatol, 2018, 2018:1-10.
    [5] CHEN JJ, HUANG JR, YANG Q, et al. Plasma exchangecentered artiifcial liver support system in hepatitis B virus-related acute-on-chronic liver failure:A nationwide prospective multicenter study in China[J]. Hepatobiliary Pancreat Dis Int, 2016, 15 (3) :275-281.
    [6] CHENG ZL, SUN GX, LIN H, et al. Efficacy and safety of plasma exchange for chronic liver failure:A Meta-analysis[J]. Chin J Evid-based Med, 2015, 15 (6) :664-671. (in Chinese) 程芝灵, 孙桂香, 林辉, 等.血浆置换治疗肝衰竭临床疗效和安全性的Meta分析[J].中国循证医学杂志, 2015, 15 (6) :664-671.
    [7] YUE-MENG W, YANG LH, YANG JH, et al. The effect of plasma exchange on entecavir-treated chronic hepatitis B patients with hepatic de-compensation and acute-onchronic liver failure[J]. Hepatol Int, 2016, 3 (10) :462-469.
    [8] CHENG Y, CHANG C, CHEN W, et al. Prognostic factors and treatment effect of standard-volume plasma exchange for acute and acute-on-chronic liver failure:A single-center retrospective study[J]. Transfus Apher Sci, 2018, 57 (4) :537-543.
    [9] ZBIGNIEW MS, JEFFREY LW, NICHOLAS B, et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Apheresis Applications Committee of the American Society for Apheresis[J]. J Clin Apher, 2010, 25 (3) :83-177.
    [10] KARVELLAS CJ, SUBRAMANIAN RM. Current evidence for extracorporeal liver support systems in acute liver failure and acute-on-chronic liver failure[J]. Crit Care Clin, 2016, 32 (3) :439-451.
    [11] LARSEN FS, SCHMIDT LE, BERNSMEIER C, et al. Highvolume plasma exchange in patients with acute liver failure:An open randomised controlled trial[J]. J Hepatol, 2016, 64 (1) :69-78.
    [12] SCHWARTZ J, PADMANABHAN A, AQUI N, et al. Guidelines on the use of therapeutic apheresis in clinical practice–evidence-based approach from the writing committee of the american society for apheresis:The seventh special issue[J].J Clin Apher, 2016, 31 (3) :149-338.
    [13] CHEN YT, WU Z, TAO SH. High volume plasma exchange in critical disease[J]. Chin Pediatr Emerg Med, 2018, 25 (5) :348-350. (in Chinese) 陈亦婷, 吴渚, 陶少华.高容量血浆置换在危重症中的应用[J].中国小儿急救医学, 2018, 25 (5) :348-350.
    [14] MCLEOD BC. Therapeutic apheresis:Use of human serum albumin, fresh frozen plasma and cryosupernatant plasma in therapeutic plasma exchange[J]. Best Pract Res Clin Haematol, 2006, 19 (1) :157-167.
    [15] STENBG P, BUSK T, LARSEN FS, et al. Efficacy of liver assisting in patients with hepatic encephalopathy with special focus on plasma exchange[J]. Metab Brain Dis, 2013, 28 (2) :333-335.
    [16] XU YQ, SHI WM, LI JS, et al. Application of plasma substitute and albumin in plasema exchange therapy of artificial liver support system:A clinical study in liver failure patients[J].Chin J Crit Care Med, 2013, 33 (9) :829-831. (in Chinese) 徐玉琴, 石文明, 李金顺, 等.代血浆加白蛋白置换液部分代替血浆进行人工肝治疗肝衰竭的临床观察[J].中国急救医学, 2013, 33 (9) :829-831.
    [17] ZHANG XF, DENG QZ, PANG ZQ, et al. Evaluation of effectiveness and safety of application of 5%albumin on artificial liver selective plasma exchange treatment[J]. China Mod Doct, 2016, 54 (13) :27-30. (in Chinese) 张行芬, 邓勤智, 庞中强, 等. 5%白蛋白用于人工肝选择性血浆置换治疗的有效性和安全性评价[J].中国现代医生, 2016, 54 (13) :27-30.
    [18] BLASI A, CID J, BELTRAN J, et al. Coagulation profile after plasma exchange using albumin as a replacement solution measured by thromboelastometry[J]. Vox Sang, 2016, 110 (2) :159-165.
    [19] XING HQ, LIU JW, WANG KL, et al. Analysis of clinical effect of continuous plasma diafiltration for the therapy of liver failure[J]. BME&Clin Med, 2013, 17 (2) :152-155. (in Chinese) 邢汉前, 刘俊微, 王开利, 等.持续缓慢血浆透析滤过治疗肝功能衰竭的临床疗效分析[J].生物医学工程与临床, 2013, 17 (2) :152-155.
    [20] EGUCHI Y, NAKAE H, FURUYA T, et al. Plasma filtration with dialysis (plasma diafiltration) in critically ill patients with acute liver failure[J]. Crit Care, 2014, 18 (1) :1-182.
    [21] NAKAE H, EGUCHI Y, SAOTOME T, et al. Multicenter study of plasma diafiltration in patients with acute liver failure[J].Ther Apher Dial, 2010, 14 (5) :444-450.
    [22] TSIPOTIS E, SHUJA A, JABER BL. Albumin dialysis for liver failure:A systematic review[J]. Adv Chronic Kidney Dis, 2015, 22 (5) :382-390.
    [23] YANG XS, ZHOU L, LI L, et al. Influence of duration of plasma diafiltration on therapeutic outcome of liver failure[J]. J Clin Hepatol, 2018, 34 (5) :1052-1054. (in Chinese) 杨仙珊, 周莉, 李璐, 等.血浆透析滤过治疗时间对肝衰竭治疗效果的影响[J].临床肝胆病杂志, 2018, 34 (5) :1052-1054.
    [24] KOMURA T, TANIGUCHI T, SAKAI Y, et al. Efficacy of continuous plasma diafiltration therapy in critical patients with acute liver failure[J]. J Gastroenterol Hepatol, 2014, 29 (4) :782-786.
    [25] LI RH, FU L, HUANG Y, et al. Clinical research of double plasma molecular absorption system in treatment of liver failure[J]. Chin J Mod Med, 2018, 28 (1) :78-82. (in Chinese) 李荣华, 傅蕾, 黄燕, 等.双重血浆分子吸附治疗肝衰竭的临床研究[J].中国现代医学杂志, 2018, 28 (1) :78-82.
    [26] ZHANG BW, YANG XF, LUO XJ, et al. Comparison of clinical effects of double plasma molecular adsorption system, plasma bilirubin adsorption and plasma exchange in liver failure[J].Chin J Mod Med, 2016, 26 (12) :103-106. (in Chinese) 张宝文, 阳学风, 罗湘俊, 等.双重血浆吸附、胆红素吸附及血浆置换治疗肝衰竭的疗效比较[J].中国现代医学杂志, 2016, 26 (12) :103-106.
    [27] WAN YM, LI YH, XU ZY, et al. Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus-infected acute-on-chronic liver failure treated by entercavir:A prospective study[J]. J Clin Apher, 2017, 32 (6) :453-461.
    [28] MAIWALL R, MARAS JS, NAYAK SL, et al. Liver dialysis in acute-on-chronic liver failure:Current and future perspectives[J]. Hepatol Int, 2014, 8 (Suppl 2) :505-513.
    [29] ZHOU PQ, ZHENG SP, YU M, et al. Prognosis of acute-on-chronic liver failure patients treated with artificial liver support system.[J]. World J Gastroenterol, 2015, 21 (32) :9614-9622.
    [30] CHE XQ, LI ZQ, CHEN Z, et al. Plasma exchange combining with plasma bilirubin adsorption effectively removes toxic substances and improves liver functions of hepatic failure patients[J]. Eur Rev Med Pharmacol Sci, 2018, 22 (4) :1118-1125.
    [31] ZHANG J, YIN F, LUO GH, et al. Effect of plasma exchange and sequential double plasma molecular adsorbent therapy on short survival in patients with hepatitis B virus-induced acute on chronic liver failure[J]. J Pract Hepatol, 2019, 22 (1) :85-88. (in Chinese) 张静, 尹芳, 罗贯虹, 等.血浆置换序贯双重血浆分子吸附治疗慢加急性乙型肝炎肝衰竭患者疗效及短期生存分析[J].实用肝脏病杂志, 2019, 22 (1) :85-88.
    [32] ZHONG S, WANG N, ZHAO J, et al. Plasma exchange combined with double plasma absorption therapy improve the prognosis of acute-on-chronic liver failure[J]. Chin J Hepatol, 2018, 26 (10) :744-749. (in Chinese) 钟珊, 王娜, 赵静, 等.血浆置换联合双重血浆吸附治疗提高慢加急性肝衰竭预后[J].中华肝脏病杂志, 2018, 26 (10) :744-749.
    [33] YAO J, LI S, ZHOU L, et al. Therapeutic effect of double plasma molecular adsorption system and sequential halfdose plasma exchange in patients with HBV-related acuteon-chronic liver failure[J]. J Clin Apher, 2019.[Epub ahead of print]
    [34] LI MQ, TI JX, ZHU YH, et al. Combined use of non-biological artificial liver treatments for patients with acute liver failure complicated by multiple organ dysfunction syndrome[J].World J Emerg Med, 2014, 5 (3) :214-217.
    [35] HANISH SM, STEIN D, SCALEA J, et al. Molecular adsorbent recirculating system effectively replaces hepatic function in severe acute liver failure[J]. Ann Surg, 2017, 266 (4) :677-684.
    [36] BAARES R, NEVENS F, LARSEN F, et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure:The RELIEF trial[J].Hepatology, 2013, 57 (3) :1153-1162.
    [37] SALIBA F, CAMUS C, DURAND F, et al. Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure:A randomized, controlled trial[J]. Ann Intern Med, 2013, 159 (8) :522-531.
    [38] GERTH H, POHLEN M, THLKING G, et al. Molecular adsorbent recirculating system can reduce short-term mortality among patients with acute-on-chronic liver failure-a retrospective analysis[J]. Crit Care Med, 2017, 45 (10) :1616-1624.
    [39] WANG XX, HUANG JR. Advances in the application of artificial liver in liver failure[J]. J Clin Hepatol, 2018, 34 (9) :1847-1854. (in Chinese) 王笑笑, 黄建荣.人工肝在肝衰竭中的应用进展[J].临床肝胆病杂志, 2018, 34 (9) :1847-1854.
    [40] LEXMOND WS, van DAEL CM, SCHEENSTRA R, et al. Experience with molecular adsorbent recirculating system treatment in 20 children listed for high-urgency liver transplantation[J].Liver Transpl, 2015, 21 (3) :369-380.
    [41] LEE KC, STADLBAUER V, JALAN R. Extracorporeal liver support devices for listed patients[J]. Liver Transpl, 2016, 22 (6) :839-848.
    [42] STADLBAUER V, KRISPER P, BEUERS U, et al. Removal of bile acids by two different extracorporeal liver support systems in acute-on-chronic liver failure[J]. ASAIO J, 2007, 53 (2) :187-193.
    [43] KOMARDINA E, YAROUSTOVSKY M, ABRAMYAN M, et al.Prometheus therapy for the treatment of acute liver failure in patients after cardiac surgery[J]. Kardiochir Torakochirurgia Pol, 2017, 14 (4) :230-235.
    [44] ANDREAS K, GUIDO G, SEBASTIAN H, et al. Effects of fractionated plasma separation and adsorption on survival in patients with acute-on-chronic liver failure[J]. Gastroenterology, 2012, 142 (4) :782-789.
    [45] SHEN Y, WANG XL, WANG B, et al. Survival benefits with artificial liver support system for acute-on-chronic liver failure:A time series-based meta-analysis[J]. Medicine (Baltimore) , 2016, 95 (3) :e2506.
    [46] ZHENG Z, LI X, LI Z, et al. Artificial and bioartificial liver support systems for acute and acute-on-chronic hepatic failure:A meta-analysis and meta-regression[J]. Exp Ther Med, 2013, 6 (4) :929-936.
    [47] WANG ZC, SHAO JG, GU EL. Short-term prediction of total bilirubin rebound rate for artificial liver treatment of acute-on-chronic hepatic failure[J]. Chin J Infect Dis, 2013, 31 (11) :678-680. (in Chinese) 王忠成, 邵建国, 顾尔莉.总胆红素反弹率对人工肝治疗慢加亚急性肝功能衰竭的短期预测[J].中华传染病杂志, 2013, 31 (11) :678-680.
    [48] GOU LM. Clinical selection of individualizd artificial liver support[J]. Chin J Clin Infect Dis, 2017, 10 (2) :113-118. (in Chinese) 郭利民.肝衰竭人工肝治疗的个体化选择[J].中华临床感染病杂志, 2017, 10 (2) :113-118.
    [49] WAN WW. Clinical efficacy of double plasma molecular adsorption system in the treatment of acute hepatic failure[J/CD]. Chin J Clinicians:Electronic Edition, 2016, 10 (7) :196-197. (in Chinese) 万维维.双重血浆分子吸附系统治疗急性肝功能衰竭的临床疗效观察[J/CD].中华临床医师杂志:电子版, 2016, 10 (7) :196-197.
    [50] GAO Y, KONG LL, XIAO QF, et al. A case of hemodialysisrelated hepatic encephalopathy[J]. Chin J Gen Pract, 2019, 18 (2) :185-186. (in Chinese) 高阳, 孔丽丽, 肖庆飞, 等.血液透析相关性肝性脑病一例[J].中华全科医师杂志, 2019, 18 (2) :185-186.
    [51] YIN GC, YA CM, LI Q, et al. Clinical experience of double plasma molecular absorption with a combination of two hemoperfusion machines in treatment of liver failure[J]. Chin Crit Care Med, 2013, 25 (12) :738-742. (in Chinese) 殷桂春, 轧春妹, 李谦, 等.两台血液灌流机组合实现双重血浆分子吸附系统治疗肝衰竭的临床研究[J].中华危重病急救医学, 2013, 25 (12) :738-742.
    [52] ZHANG B, YANG YG, GONG YY, et al. Clinical application of double plasma molecular adsorption system in treatment of acute liver failure[J]. World Chin J Dig, 2015, 23 (29) :4720-4724. (in Chinese) 张斌, 杨永耿, 巩月英, 等.双重血浆分子吸附治疗急性肝衰竭的临床应用[J].世界华人消化杂志, 2015, 23 (29) :4720-4724.
    [53] WANG GH, LIU KH, ZHANG XY, et al. The clinical efficacy analysis of plasma exchange combined with plasma perfusion in treatment of acute liver failure[J]. Chin J Gastroenter Hepatol, 2017, 26 (11) :100-103. (in Chinese) 王盖昊, 刘凯辉, 张潇艺, 等.血浆置换联合血浆灌流治疗急性肝衰竭的临床疗效分析[J].胃肠病学和肝病学杂志, 2017, 26 (11) :100-103.
    [54] FUJIWARA K, ODA S, ABE R, et al. On-line hemodiafiltration or high-flow continuous hemodiafiltration is one of the most effective artificial liver support devices for acute liver failure in Japan[J]. J Hepatobiliary Pancreat Sci, 2015, 22 (3) :246-247.
    [55] LEE WM, STRAVITZ RT, LARSON AM. Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011[J]. Hepatology, 2012, 55 (3) :965-967.
    [56] CERDJ, TOLWANI A, GIBNEY N, et al. Renal replacement therapy in special settings:Extracorporeal support devices in liver failure[J]. Semin Dial, 2011, 24 (2) :197-202.
    [57] ZHANG L, TANG LB, JIANG JJ, et al. Treatment of hepatic failure with hepatorenal syndrome by non-biological artificial liver technique[J]. J Kunming Med Univ, 2017, 38 (6) :36-39. (in Chinese) 张乐, 唐理斌, 姜建杰, 等.非生物型人工肝技术治疗肝衰竭合并肝肾综合征[J].昆明医科大学学报, 2017, 38 (6) :36-39.
    [58] WANG Y, GUO LM, XIONG HF, et al. Treatment of patients with liver failure using fractional plasma diafiltration:An analysis of 56 cases[J]. World Chin J Dig, 2009, 17 (23) :2433-2437. (in Chinese) 王宇, 郭利民, 熊号峰, 等.不同成分血浆滤过透析治疗重型肝炎患者56例[J].世界华人消化杂志, 2009, 17 (23) :2433-2437.
    [59] LIU HL, LI YY, LI H. Curative effect of CRRT combined with PE in the treatment of advanced severe hepatitis complicated with hepatorenal syndrome[J]. Chin Hepatol, 2016, 21 (8) :647-649. (in Chinese) 刘红凌, 李艳英, 李华. CRRT与PE联合治疗晚期重症肝炎合并肝肾综合征的疗效分析[J].肝脏, 2016, 21 (8) :647-649.
    [60] KARVELLAS CJ, BAGSHAW SM. Advances in management and prognostication in critically ill cirrhotic patients[J]. Curr Opin Crit Care, 2014, 20 (2) :210-217.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1434) PDF downloads(411) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return