Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions

作     者：Panagiotis Papamichalis Katerina G Oikonomou Asimina Valsamaki Maria Xanthoudaki Periklis Katsiafylloudis Evangelia Papapostolou Apostolia-Lemonia Skoura Michail Papamichalis Marios Karvouniaris Antonios Koutras Eleni Vaitsi Smaragdi Sarchosi Antonios Papadogoulas Dimitrios Papadopoulos 

作者机构：Intensive Care UnitGeneral Hospital of LarissaLarissa 41221ThessalyGreece Department of Transfusion MedicineUniversity Hospital of LarissaLarissa 41110ThessalyGreece Department of CardiologyUniversity Hospital of LarissaLarissa 41110ThessalyGreece Intensive Care UnitAHEPA University HospitalThessaloniki 54636Greece 1^(st) Department of Obstetrics and GynecologyGeneral Hospital of Athens“ALEXANDRA”National and Kapodistrian University of AthensAthens 11528Greece Department of AnesthesiologyUniversity Hospital of LarissaLarissa 41110ThessalyGreece 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2023年第11卷第17期

页      面：3932-3948页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Liver failure Transplantation Blood purification Liver replacement therapy Artificial extracorporeal systems Transplant-free survival 

摘      要：Clinically,it is highly challenging to promote recovery in patients with acute liver failure(ALF)and acute-on-chronic liver failure(ACLF).Despite recent advances in understanding the underlying mechanisms of ALF and ACLF,standard medical therapy remains the primary therapeutic *** transplantation(LT)is considered the last option,and in several cases,it is the only intervention that can be ***,this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a *** option is to restore impaired liver function with artificial extracorporeal blood purification *** first such systems were developed at the end of the 20th century,providing solutions as bridging therapy,either for liver recovery or *** enhance the elimination of metabolites and substances that accumulate due to compromised liver *** addition,they aid in clearance of molecules released during acute liver decompensation,which can initiate an excessive inflammatory response in these patients causing hepatic encephalopathy,multiple-organ failure,and other complications of liver *** compared to renal replacement therapies,we have been unsuccessful in using artificial extracorporeal blood purification systems to completely replace liver function despite the outstanding technological evolution of these *** middle to high-molecular-weight and hydrophobic/protein-bound molecules remains extremely *** majority of the currently available systems include a combination of methods that cleanse different ranges and types of molecules and ***,conventional methods such as plasma exchange are being re-evaluated,and novel adsorption filters are increasingly being used for liver *** strategies are very promising for the treatment of liver ***,the best method,system,or device has not been developed yet,and its probability of