Assessment of resin perfusion in hepatic failure in vitro and in vivo.
OBJECTIVE
To observe the adsorbent effect of resin on endotoxin, cytokine, bilirubin in plasma of patients with hepatic failure and to determine the resin perfusion as an artificial liver support system in the treatment of hepatic failure.


METHODS
One thousand milliliters of discarded plasma was collected from each of 6 severe hepatitis patients treated with plasma exchange. The plasma was passed through a resin perfusion equipment for 1-2 h via extracorporeal circulation, and then absorbent indicators of transaminase, bilirubin, blood ammonia, endotoxin and cytokines were examined. In the meantime, study of in vivo resin plasma perfusion was performed on 7 severe hepatitis patients to compare the changes of endotoxin and cytokines in blood before and after perfusion.


RESULTS
The levels of total bilirubin, endotoxin, interleukin 1beta and TNF-alpha in plasma were significantly decreased after in vitro resin plasma perfusion. The levels of interleukin 1beta, TNF-alpha and endotoxin in blood were also evidently declined after in vivo resin plasma perfusion. Nevertheless, no obvious changes in IL-6, creatinine (Cr) and urea nitrogen (UN), blood ammonia and electrolytes were found both in vitro and in vivo.


CONCLUSIONS
Bilirubin, endotoxin and cytokines in plasma of patients with hepatic failure can be effectively adsorbed by resin in vitro. Most cytokines and endotoxin in plasma can also be effectively removed by resin in vivo. It demonstrates that resin perfusion may have good treatment efficacy on hepatic failure and can be expected to slow down the progression of hepatic failure.
Wang
Ying-Jie
YJ
Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. wangyj103@263.net
Wang
Ze-Wen
ZW
Luo
Bing-Wei
BW
Liu
Hong-Ling
HL
Wen
Hong-Wei
HW
D000328:Adult; D001663:Bilirubin / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood; D017093:Liver Failure / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012117:Resins, Synthetic / Q000627:therapeutic use*; D000637:Transaminases / Q000097:blood
D016207:Cytokines; D008070:Lipopolysaccharides; D012117:Resins, Synthetic; D000637:Transaminases; D001663:Bilirubin