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Is extra-corporal liver support with prometheus safe in patients with end-stage liver disease?

Patients with end-stage liver disease would benefit from liver supportive liver therapy while waiting for stabilization of hepatic functions or to enable bridging to liver transplantation. Albumin dialysis improves patients' general condition, including cardiovascular and renal function as well as the degree of hepatic encephalopathy. Studies evaluating the hemodynamic alterations in stable patients with cirrhosis during extra-corporal intervention remain scarce, though such knowledge might evidently improve patient safety and perhaps lessen reluctance toward the early use of extra-corporal liver support.

The decision to use extra-corporal liver support in the treatment of patients with end-stage liver disease hinges on many factors, with safety considerations a major concern. The choice of treatment will depend on the risk of adverse events, and possible positive or negative hemodynamic influences between the available treatment modalities.

A research article to be published on April 7, 2008 in the World Journal of Gastroenterology addresses these issues. In this clinical study, the authors aimed to determine the hemodynamic profile of intervention with Prometheus, using MARS and hemodialysis as control groups, in patients with end-stage liver disease. They found the Prometheus system does not aggravate the systemic hemodynamics. However, Prometheus therapy does not exert an equally beneficial influence on arterial pressure as seen during MARS treatment. It was concluded that an intervention using extra-corporal liver support with albumin-dialysis should not be withheld merely because of safety considerations in the future.


Contact: Jing Zhu
World Journal of Gastroenterology

Page: 1

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