Arterial steroid injection therapy can inhibit the progression of severe acute hepatic failure toward fulminant liver failure.
OBJECTIVE
To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic failure.


METHODS
Thirty-four patients with severe acute hepatic failure were admitted to our hospital between June 2002 to June 2006 providing for the possibility of liver transplantation (LT). Seventeen patients were treated using traditional liver supportive procedures, and the other 17 patients additionally underwent TASIT with 1000 mg methylprednisolone per day for 3 continuous days.


RESULTS
Of the 17 patients who received TASIT, 13 were cured without any complications, 2 died, and 2 underwent LT. Of the 17 patients who did not receive TASIT, 4 were self-limiting, 7 died, and 6 underwent LT. Univariate logistic analysis revealed that ascites, serum albumin, prothrombin time, platelet count, and TASIT were significant variables for predicating the prognosis. Multivariate logistic regression analysis using stepwise variable selection showed that prothrombin time, platelet count, and TASIT were independent predictive factors.


CONCLUSIONS
TASIT might effectively prevent the progression of severe acute hepatic failure to a fatal stage of fulminant liver failure.
Kotoh
Kazuhiro
K
Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. kotoh-k@intmed3.med.kyushu-u.ac.jp
Enjoji
Munechika
M
Nakamuta
Makoto
M
Yoshimoto
Tsuyoshi
T
Kohjima
Motoyuki
M
Morizono
Shusuke
S
Yamashita
Shinsaku
S
Horikawa
Yuki
Y
Yoshimitsu
Kengo
K
Tajima
Tsuyoshi
T
Asayama
Yoshiki
Y
Ishigami
Kousei
K
Hirakawa
Masakazu
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D017114:Liver Failure, Acute / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D008264:Macrophages / Q000187:drug effects; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone