title: Effect of Prometheus liver assist system on systemic hemodynamics in patients with cirrhosis: a randomized controlled study.
abstract: OBJECTIVE
  To evaluate treatment safety and hemodynamic changes during a single 6-h treatment with the Prometheus liver assist system in a randomized, controlled study.
  
  
  METHODS
  Twenty-four patients were randomized to either the study group or to one of two control groups: Fractionated Plasma Separation Adsorption and Dialysis, Prometheus system (Study group; n = 8); Molecular Adsorbent Recirculation System (MARS) (Control group 1, n = 8); or hemodialysis (Control group 2; n = 8). All patients included in the study had decompensated cirrhosis at the time of the inclusion into the study. Circulatory changes were monitored with a Swan-Ganz catheter and bilirubin and creatinine were monitored as measures of protein-bound and water-soluble toxins.
  
  
  RESULTS
  Systemic hemodynamics did not differ between treatment and control groups apart from an increase in arterial pressure in the MARS group (P = 0.008). No adverse effects were observed in any of the groups. Creatinine levels significantly decreased in the MARS group (P = 0.03) and hemodialysis group (P = 0.04). Platelet count deceased in the Prometheus group (P = 0.04).
  
  
  CONCLUSIONS
  Extra-corporal liver support with Prometheus is proven to be safe in patients with endstage liver disease but does not exert the beneficial effects on arterial pressure as seen in the MARS group.
authors.affiliation: Department of Hepatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Dethloff
authors.forename: Flemming
authors.initials: F
authors.lastname: Tofteng
authors.forename: Hans-Jorgen
authors.initials: HJ
authors.lastname: Frederiksen
authors.forename: Michael
authors.initials: M
authors.lastname: Hojskov
authors.forename: Bent-Adel
authors.initials: BA
authors.lastname: Hansen
authors.forename: Fin-Stolze
authors.initials: FS
authors.lastname: Larsen
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology; D001663:Bilirubin / Q000378:metabolism; D001794:Blood Pressure; D003404:Creatinine / Q000737:chemistry; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy*; D017093:Liver Failure / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D016060:Sorption Detoxification / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D003404:Creatinine; D001663:Bilirubin