Acute liver failure future or investigational therapies: Difference between revisions
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==Liver Support Systems== | ==Liver Support Systems== | ||
Liver Support Systems are the support devices helping in providing some time to help failing liver to recover. These can also be used as a bridge to transplantation. There are two kinds of devices sorbent based artificial system and cell based bio-artificial system. There is no good evidence showing low mortality with their use in acute liver failure<ref name="pmid18336699">{{cite journal |author=Freeman RB, Steffick DE, Guidinger MK, Farmer DG, Berg CL, Merion RM |title=Liver and intestine transplantation in the United States, 1997-2006 |journal=[[American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons]] |volume=8 |issue=4 Pt 2 |pages=958–76 |year=2008 |month=April |pmid=18336699 |doi=10.1111/j.1600-6143.2008.02174.x |url=http://dx.doi.org/10.1111/j.1600-6143.2008.02174.x |accessdate=2012-10-26}}</ref>. They are not recommended outside of clinical trials as of now. | Liver Support Systems are the support devices helping in providing some time to help failing liver to recover. These can also be used as a bridge to transplantation. There are two kinds of devices sorbent based artificial system and cell based bio-artificial system. There is no good evidence showing low mortality with their use in acute liver failure<ref name="pmid18336699">{{cite journal |author=Freeman RB, Steffick DE, Guidinger MK, Farmer DG, Berg CL, Merion RM |title=Liver and intestine transplantation in the United States, 1997-2006 |journal=[[American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons]] |volume=8 |issue=4 Pt 2 |pages=958–76 |year=2008 |month=April |pmid=18336699 |doi=10.1111/j.1600-6143.2008.02174.x |url=http://dx.doi.org/10.1111/j.1600-6143.2008.02174.x |accessdate=2012-10-26}}</ref>. They are not recommended outside of clinical trials as of now. | ||
===2011 AASLD Recommendations : Liver Support Systems <ref name="urlwww.aasld.org">{{cite web |url=http://www.aasld.org/practiceguidelines/Documents/AcuteLiverFailureUpdate2011.pdf |title=www.aasld.org |format= |work= |accessdate=2012-10-26}}</ref>(DO NOT EDIT)=== | |||
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| style="text-align:center" | [[AASLD guidelines classification scheme#Classification of Recommendations|Class II-1]] | |||
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|'''1.''' | |||
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==Other Strategies== | ==Other Strategies== | ||
Other strategies include exchange transfusion, charcoal hemoperfusion, extracorporeal liver perfusions<ref name="pmid8938179">{{cite journal |author=Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG, Kelly JH, Gislason GT, Sussman NL, Williams R |title=Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure |journal=[[Hepatology (Baltimore, Md.)]] |volume=24 |issue=6 |pages=1446–51 |year=1996 |month=December |pmid=8938179 |doi=10.1002/hep.510240625 |url=http://dx.doi.org/10.1002/hep.510240625 |accessdate=2012-10-26}}</ref><ref name="pmid8015570">{{cite journal |author=Chari RS, Collins BH, Magee JC, DiMaio JM, Kirk AD, Harland RC, McCann RL, Platt JL, Meyers WC |title=Brief report: treatment of hepatic failure with ex vivo pig-liver perfusion followed by liver transplantation |journal=[[The New England Journal of Medicine]] |volume=331 |issue=4 |pages=234–7 |year=1994 |month=July |pmid=8015570 |doi=10.1056/NEJM199407283310404 |url=http://www.nejm.org/doi/abs/10.1056/NEJM199407283310404?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov |accessdate=2012-10-26}}</ref>, and intra-portal hepatocyte infusions. All these are still under trials and no evidence of good prognosis is demonstrated. | Other strategies include exchange transfusion, charcoal hemoperfusion, extracorporeal liver perfusions<ref name="pmid8938179">{{cite journal |author=Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG, Kelly JH, Gislason GT, Sussman NL, Williams R |title=Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure |journal=[[Hepatology (Baltimore, Md.)]] |volume=24 |issue=6 |pages=1446–51 |year=1996 |month=December |pmid=8938179 |doi=10.1002/hep.510240625 |url=http://dx.doi.org/10.1002/hep.510240625 |accessdate=2012-10-26}}</ref><ref name="pmid8015570">{{cite journal |author=Chari RS, Collins BH, Magee JC, DiMaio JM, Kirk AD, Harland RC, McCann RL, Platt JL, Meyers WC |title=Brief report: treatment of hepatic failure with ex vivo pig-liver perfusion followed by liver transplantation |journal=[[The New England Journal of Medicine]] |volume=331 |issue=4 |pages=234–7 |year=1994 |month=July |pmid=8015570 |doi=10.1056/NEJM199407283310404 |url=http://www.nejm.org/doi/abs/10.1056/NEJM199407283310404?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov |accessdate=2012-10-26}}</ref>, and intra-portal hepatocyte infusions. All these are still under trials and no evidence of good prognosis is demonstrated. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Liver support systems help in supporting the patients until the liver recovers or can be used as a bridging aid for transplantation.
Liver Support Systems
Liver Support Systems are the support devices helping in providing some time to help failing liver to recover. These can also be used as a bridge to transplantation. There are two kinds of devices sorbent based artificial system and cell based bio-artificial system. There is no good evidence showing low mortality with their use in acute liver failure[1]. They are not recommended outside of clinical trials as of now.
2011 AASLD Recommendations : Liver Support Systems [2](DO NOT EDIT)
| Class II-1 |
| 1. |
Other Strategies
Other strategies include exchange transfusion, charcoal hemoperfusion, extracorporeal liver perfusions[3][4], and intra-portal hepatocyte infusions. All these are still under trials and no evidence of good prognosis is demonstrated.
References
- ↑ Freeman RB, Steffick DE, Guidinger MK, Farmer DG, Berg CL, Merion RM (2008). "Liver and intestine transplantation in the United States, 1997-2006". American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 8 (4 Pt 2): 958–76. doi:10.1111/j.1600-6143.2008.02174.x. PMID 18336699. Retrieved 2012-10-26. Unknown parameter
|month=ignored (help) - ↑ "www.aasld.org" (PDF). Retrieved 2012-10-26.
- ↑ Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG, Kelly JH, Gislason GT, Sussman NL, Williams R (1996). "Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure". Hepatology (Baltimore, Md.). 24 (6): 1446–51. doi:10.1002/hep.510240625. PMID 8938179. Retrieved 2012-10-26. Unknown parameter
|month=ignored (help) - ↑ Chari RS, Collins BH, Magee JC, DiMaio JM, Kirk AD, Harland RC, McCann RL, Platt JL, Meyers WC (1994). "Brief report: treatment of hepatic failure with ex vivo pig-liver perfusion followed by liver transplantation". The New England Journal of Medicine. 331 (4): 234–7. doi:10.1056/NEJM199407283310404. PMID 8015570. Retrieved 2012-10-26. Unknown parameter
|month=ignored (help)