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Hepatobiliary & Pancreatic Diseases International 2004年第2期3卷 316-317页

作者： Yi-He Liu, Yu Wang, Li-Xin Yu, Li-Ying Sun, Bao-Lan Feng, Zhong-Yang Shen and Min-Min Wang Tianjin, ChinaTianjin Organ Transplantation Institute, Tianjin First Central Hospital, Tianjin 300192 , China Therapeutic Blood Purification Research Cen- ter , University of Rostock, Germany Tianjin Organ Transplantation Institute Tianjin First Central Hospital Tianjin 300192 China.

BACKGROUND: Molecular adsorbents recirculating sys- tem (MARS) liver support therapy is the development of albumin dialysis. This study was to assess the successful ap- plication of MARS artificial liver support therapy as a bridge to re-transplantation in two cases of long anhepatic duration. METHODS: MARS therapy was given after failure plasma- exchange ( PE) treatment, which resulted in circulatory de- rangement and acute renal dysfunction in a 36-year-old male patient. Finally his uncontrolled anhepatic condition led to a successful re-transplantation. In another 48-year- old man who was diagnosed as having primary nonfunction (PNF) during the liver transplantation, 10-hour MARS treatment contributed to smooth bridging of his anhepatic phase. RESULTS: The two anhepatic patients were bridged for 26 and 17 hours respectively to re-transplantation with MARS therapy. CONCLUSION: Our experience proves that MARS artifi- cial liver can be an effective support for long time bridging PNF until re-transplantation is available.

关键词： artificial liver support liver transplantation anhepatic molecular adsorbents recirculating system

Plasma exchange-centered artificial liver support system in hepatitis B virus-related acute-onchronic liver failure:a nationwide prospective multicenter study in China

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Hepatobiliary & Pancreatic Diseases International 2016年第3期15卷 275-281页

作者： Jia-Jia Chen Jian-Rong Huang Qian Yang Xiao-Wei Xu Xiao-Li Liu Shao-Rui Hao Hui-Fen Wang Tao Han Jing Zhang Jian-He Gan Zhi-Liang Gao Yu-Ming Wang Shu-Mei Lin Qing Xie Chen Pan Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases and Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesFirst Affiliated HospitalZhejiang University School of Medicine liver Failure Therapy and Research Center 302 Hospital of People’s Liberation Army Department of Hepatology Third Central Clinical College of Tianjin Medical University artificial liver Center You’an HospitalCapital Medical University Department of Infectious Diseases First Affiliated Hospital of Suzhou University Department of Infectious Diseases Third Affiliated Hospital of Sun Yat-Sen University Institute of Infectious Diseases Southwest HospitalThird Military Medical University Department of Infectious Diseases First Affiliated Hospital of Xi’an Jiaotong University Department of Infectious Diseases Ruijin HospitalShanghai Jiaotong University School of Medicine Department of Infectious Diseases Infectious Diseases Hospital Affiliated to Fujian Medical University

BACKGROUND： Plasma exchange （PE）-centered artificial liver support system reduced the high mortality rate of hepa titis B virus （HBV）-related acute-on-chronic liver failure （ACLF）. But the data were diverse in different medical centers. The present prospective nationwide study was to evaluate the effects of PE on patients with HBV-ACLF at different stages.

关键词： liver failure artificial liver support plasma exchange acute-on-chronic liver failure

Major liver resections,perioperative issues and posthepatectomy liver failure:A comprehensive update for the anesthesiologist

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World Journal of Critical Care Medicine 2024年第2期13卷 49-71页

作者： Andrea De Gasperi Laura Petrò Ombretta Amici Ilenia Scaffidi Pietro Molinari Caterina Barbaglio Eva Cibelli Beatrice Penzo Elena Roselli Andrea Brunetti Maxim Neganov Alessandro Giacomoni Paolo Aseni Elena Guffanti Former Head Anesthesia and Critical Care Service 2Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy AR1 Ospedale Papa Giovanni 23Bergamo 24100Italy Anesthesia and Critical Care Service 2 Grande Ospedale Metropolitano Niguarda AR2ASST GOM NiguardaMilan 20163Italy Anestesia e Terapia Intensiva Generale Istituto Clinico HumanitasRozzano 20089Italy Chirurgia Oncologica Miniinvasiva Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilan 20163Italy Dipartimento di Medicina d’Urgenza ed Emergenza Grande Ospedale Metropolitano Niguarda ASST GOM NiguardaMilano 20163MIItaly

Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver *** support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved *** postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative ***,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or *** review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward *** a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.

关键词： liver resection Chronic liver disease Preoperative assessment Vascular clamping Intraoperative hemodynamic monitoring Postoperative intensive care unit Posthepatectomy liver failure artificial liver support

Therapeutic application of molecular adsorbents recirculating system in various pathogenic MODS/MOF patients

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Chinese Medical Journal 2005年第13期118卷 1113-1117页

作者： LUOHong-tao GUOLi-min WUMin LIUQuan-mei WANGMin-min DepartmentofInfectiousDiseases FirstPeople＇sHospitalofFoshanFoshan528000China ITUandartificialliversupportCenter BeijingDitanHospitalBeijing100011China ITUandBloodPurificationCenter FirstPeople＇sHospitalofFoshanFoshan528000China TherapeuticBloodPurificationResearchCenter UniversityofRostockGermany

Multiple organ dysfunction syndrome (MODS) or multiple organ failure ( MOF)is a syndrome which is frequently related to shock and sepsis, and has been described as the mostcommon cause of death in the noncoronary critical care unit. The potential pathogenesis of theseptic and systemic inflammatory response syndrome (SIRS) response has been increasingly associatedwith the development and aggravation of MODS or MOF. And studies in this respect have alsodemonstrated that there is a higher risk of mortality associated with some specific organ systemswhen they are dysfunctional, thus leading to the failures of the liver, brain, lung, and kidney. Theliver interacts with many other organ systems, and liver dysfunction may act collectively in theproduction of organ system dysfunction, thus finally ending up with MODS. The management of patientswith MODS/MOF is predominantly supportive and some specific treatments are directed at treating theunderlying disorders. The molecular adsorbent recirculating system (MARS) is an albumin dialysissystem and it was shown to be efficient in removing both hydrosoluble substances and stronglyalbumin-bound substances, so that it improves not only the function of the liver but also that ofother organ systems, and it can be applied to treating the diseased liver as the cause of multipleorgan failure and actively combat deterioration in patients' liver function. This trial aims atevaluating the therapeutic effectiveness of MARS in 39 various pathogenic MODS patients in ourhospital and Beijing Ditan Hospital.

关键词： liver failure artificial liver support molecular absorbents recirculatingsystem multiple organ dysfunction syndrome nitiric oxide cytokine

Efficacy of liver transplantation for acute hepatic failure:asingle-center experience

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Hepatobiliary & Pancreatic Diseases International 2011年第4期10卷 369-373页

作者： Xian-Jie Shi,Hong-Bin Xu,Wen-Bin Ji,Yu-Rong Liang,Wei-Dong Duan,Lei He,Ming-Jun Wang and Zhi-Ming Zhao Department of Hepatobiliary Surgery Department of Anesthesiology General Hospital of PLA,Beijing 100853,China Department of Hepatobiliary Surgery General Hospital of PLA Beijing 100853 China Department of Anesthesiology General Hospital of PLA Beijing 100853 China

BACKGROUND:Acute hepatic failure (AHF) is a devastating clinical syndrome with a high mortality *** outcome of AHF varies with etiology,but liver transplantation (LT) can significantly improve the prognosis and survival rate of such *** study aimed to detect the role of LT and artificial liver support systems (ALSS) for AHF patients and to analyze the etiology and outcome of patients with this ***:A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our *** analyzed and compared the etiology,outcome,prognosis,and survival rates of patients between the transplantation (LT) group and the non-transplantation (N-LT) ***:AHF was due to viral hepatitis in 25 patients (52.1%;hepatitis B virus in 22),drug or toxic reactions in 14 (29.2%;acetaminophen in 6),Wilson disease in 4 (8.3%),unknown reasons in 3 (6.3%),and miscellaneous conditions in 2 (4.2%).In the LT group,36 patients (7 underwent living donor LT,and 29 cadaveric LT) had an average model for endstage liver disease score (MELD) of ***-eight patients survived with good graft function after a follow-up of 27.3± 4.5 *** the waiting time,6 patients were treated with ALSS and 2 of them died during *** 30-day,12-month,and 18-month survival rates were 77.8%,72.2%,and 66.7%,*** the N-LT group,12 patients had an average MELD score of *** patients were treated with ALSS and all died during *** 90-day and 1-year survival rates were only 16.7% and 8.3%,***:Hepatitis is the most prominent cause of AHF at our *** patients with AHF,who fulfill the Kings College Criteria for LT,did not survive longer without *** did not improve the prognosis of AHF patients,but may extend the waiting time for a ***,LT is still the most effective way to improve the prognosis of AHF patients.

关键词： acute hepatic failure liver transplantation artificial liver support prognosis survival rate etiology