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.
Division of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hannover, Germany. rifai.k@gmx.de
Kinan
K
Rifai
Thomas
T
Ernst
Ulrich
U
Kretschmer
Carsten
C
Hafer
Hermann
H
Haller
Michael Peter
MP
Manns
Danilo
D
Fliser
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