The decrease in cytokine concentration during albumin dialysis correlates with the prognosis of patients with acute on chronic liver failure.
OBJECTIVE
The clearance of plasma cytokines by means of albumin dialysis (MARS) has been demonstrated in various studies involving patients affected by either acute liver failure (ALF) or acute on chronic liver failure. The aim of the study was to measure the plasma levels of TNF-alpha, IL-6, and IL-1beta in patients with ALF after each MARS treatment to evaluate the relationship between variations in cytokines levels and patient prognosis.


METHODS
Ten patients with ALF undergoing several MARS treatments were enrolled (group 1). Blood samples were collected before and after each MARS treatment to measure TNF-alpha, IL-6, and IL-1beta, and other hematochemical parameters. We also enrolled 10 patients with ALF who underwent standard therapy (group 2) as well as a control group of 10 healthy subjects matched for sex and age (group 3).


RESULTS
MARS reduced total bilirubin levels, biliary acids, BUN, ammonia, TNF-alpha, IL-6, and IL-1beta (P < .05). Moreover, the reduction in inflammatory cytokines levels and improved prognosis were related.


CONCLUSIONS
We confirmed the therapeutic efficacy of MARS treatment for ALF, which appeared to be related to removal of toxins and inflammatory cytokines determine that which patients prognosis.
Di Campli
C
C
Department of Medical Pathology, Catholic University of Rome, Rome, Italy.
Zocco
M A
MA
Gaspari
R
R
Novi
M
M
Candelli
M
M
Santoliquido
A
A
Flore
R
R
Tondi
P
P
Proietti
R
R
Gasbarrini
G
G
Pola
P
P
Gasbarrini
A
A
D000328:Adult; D000641:Ammonia / Q000097:blood; D001663:Bilirubin / Q000097:blood*; D002675:Child, Preschool; D002908:Chronic Disease; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood; D017093:Liver Failure / Q000628:therapy*; D017114:Liver Failure, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D016060:Sorption Detoxification / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D000641:Ammonia; D001663:Bilirubin