The Prometheus device for extracorporeal support of combined liver and renal failure.
OBJECTIVE
Prometheus is a newly developed extracorporeal liver support system that combines removal of albumin-bound substances (adsorption on resin adsorbers) and water-soluble substances (diffusion during high-flux hemodialysis). Therefore, it is a promising treatment option for patients with hepatorenal syndrome (HRS).


METHODS
We studied 10 patients with HRS in a prospective clinical study. All patients underwent 2 consecutive Prometheus treatments. A variety of clinical and biochemical parameters were assessed.


RESULTS
Prometheus treatment was uncomplicated and safe. A statistically significant improvement of serum creatinine and urea concentrations as well as blood pH was observed after Prometheus treatment. Furthermore, liver detoxification was supported by a significant decrease of serum levels of conjugated bilirubin, bile acids and ammonia.


CONCLUSIONS
Prometheus is a safe treatment for patients with HRS. Both, albumin-bound and water-soluble substances were effectively removed. Controlled studies will evaluate the effect of this new treatment option on survival in patients with HRS.
Rifai
Kinan
K
Division of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hannover, Germany. rifai.k@gmx.de
Ernst
Thomas
T
Kretschmer
Ulrich
U
Hafer
Carsten
C
Haller
Hermann
H
Manns
Michael Peter
MP
Fliser
Danilo
D
D001774:Blood Chemical Analysis; D005112:Extracorporeal Circulation / Q000295:instrumentation*; D005260:Female; D006530:Hepatorenal Syndrome / Q000628:therapy*; D006801:Humans; D017114:Liver Failure, Acute / Q000628:therapy; D008297:Male; D012709:Serum Albumin / Q000302:isolation & purification
D012709:Serum Albumin