[A pilot study of using pure albumin as a dialysate in the treatment of liver failure].
OBJECTIVE
To observe the effect of a new extracorporeal hepatic support-hemodialysis with albumin-based dialysate on patient with liver failure, and to compare the result with that of molecular absorbent recycling system (MARS).


METHODS
Eighteen patients with liver failure were enrolled and treated intermittently with artificial liver on the basis of conventional regime. Among them, 12 of them were treated with single albumin dialysis (SAD) for 6 hours each period, and 6 with MARS for 6 hours. During each session of SAD, 4,000 ml albumin-based dialysate (45 g/L) was circulated in the dialysate route at a flow rate of 10 L/h with the blood flow rate of 250 ml/min. Liver and renal function, prothrombin activity (PTA), serum ammonia (NH(3)), endotoxin were monitored before and after the treatment, and the serial bilirubin content was measured in the serum and the albumin dialysate of all patients respectively 1-hour, 3-hour, 6-hour after the treatment with SAD.


RESULTS
After treatment with SAD, the clinical symptoms and signs were improved and the hemodynamics were stabilized, complications were ameliorated partially, in particular hepatic encephalopathy was improved, with low incidence of adverse reaction, and the effective rate and survival rate were high. The serum PTA was increased obviously (P<0.05), and the serum blood urea nitrogen (BUN), serum creatinine (SCr), total bilirubin (TB), total bile acid (TBA), NH(3), endotoxin were decreased significantly (all P<0.05), and elimination of bilirubin slowed down gradually. The results showed that SAD was as effective as MARS, with a lower cost, and simpler and more convenient than MARS.


CONCLUSIONS
Single albumin dialysis may eliminate protein-bound and water-soluble hepatic toxins, improve clinical symptoms and liver function in the treatment of liver failure, and worth further clinical study.
Liu
Qiang
Q
The Center of Blood Purification, The Fifth Affiliated Hospital of Zhongshan University, Zhuhai 519000, Guangdong, China.
Peng
Li
L
Du
Yi
Y
Li
Mi
M
Jia
Ning
N
Zou
He-qun
HQ
D000328:Adult; D000418:Albumins / Q000627:therapeutic use*; D015314:Dialysis Solutions / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017093:Liver Failure / Q000628:therapy*; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016060:Sorption Detoxification / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
D000418:Albumins; D015314:Dialysis Solutions