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Molecular adsorbent recirculating system therapy in a rare case of fulminant hepatitis

Journal of Biomedical Science and Engineering 2012年第5期5卷 270-275页

作者： Vincenzo Morabito Giancarlo Ferretti Francesco Pugliese Simone novelli Massimo Rossi gilnardo novelli Department “P. Stefanini” General Surgery and Organs Transplant Sapienza University of Rome Rome Italy Department of Aenesthetic Science and Critical Care Medicine Sapienza University of Rome Rome Italy Department of Clinical Engineering Sapienza University of Rome Rome Italy Department of Infectous Disease Sapienza University of Rome Rome Italy

Background: Acute hepatitis C virus infection leading to fulminant hepatitis is very rare whereas Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. The repertoire of substances that accumulate in the blood in fulminant hepatic failure cause neurological abnormalities, aggravate injury to the liver and other organs, suppress the ability of residual hepatocytes to perform organ-specific functions (sick cell syndrome), and inhibit the hepatic regenerative response especially in fulminant hepatitis Virus C which has subacute clinical evolution and takes time to manifest. Liver support technology is evolving as different techniques become available that assist the remaining functional cell mass by providing specific liver functions. Case Presentation: We report a case of Fulminant C virus Hepatitis, successfully treated with albumin dialysis Molecular Adsorbent Recirculating System (MARS). At time of admittance the patient presented: Model End-stage Liver Disease (MELD)-36;Child Turcotte Pugh (CTP)-C(13);Sequential Organ Failure Assestment (SOFA)-12, Glasgow Coma Score (GCS)-11. The patient underwent six sessions of MARS in Intensive Care Unit (ICU) in association with standard medical therapy (SMT). The patient survived and was discharged from the hospital in good condition after 40 days without liver transplantation (LT).

关键词： Acute Liver Failure Hepatic Devices Cytokines Molecular Adsorbent Recirculating System

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Polymixin-B hemoperfusion in a case intolerant to conventional antibiotic therapy

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Journal of Biomedical Science and Engineering 2012年第3期5卷 101-103页

作者： gilnardo novelli Vincenzo Morabito Giancarlo Ferretti Simone novelli Franco Ruberto Milena Pernice Cristina Cristina Donfrancesco Perluigi Benedetti Panici Department “Paride Stefanini” General Surgery and Organs Transplant Sapienza University Rome Italy Department “Paride Stefanini” General Surgery and Organs Transplant Sapienza University Rome Italy 2Department of Department of Anesthesia and Intensive Care Sapienza University Rome Italy 5Department of Department of Clinical Engineering Sapienza University Rome Italy Department of Gynecology and Obstretics Sapienza University Rome Italy Department of Tropical and Infectous Disease Sapienza University Rome Italy

In this study we document how it was possible to resolve the septic complications of abdominal surgery, subjecting a patient severely allergic to intravenous antibiotics. We performed the hemoperfusion with polymyxin-B columns (PMX-DHP), guiding the therapy by assaying endotoxin activity and evaluating the clinical status of the patient after each session of PMX-DHP. The stabilization of hemodynamic and inflammatory frameworks were immediately observed after the PMX-DHP. The patient could be safely discharged five days after the discontinuation of the therapy. Our findings confirms data already published in literature concerning the effectiveness of PMX-DHP.

关键词： Sepsis Endotoxin Activity Antibiotics

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