title: Efficient removal of serum bilirubin by a novel artificial liver support system using albumin convection: a pilot study.
abstract: OBJECTIVE
  To compare the efficacy of a new artificial liver support system, fractionated plasma separation and adsorption integrated with hemofiltration, with the old system, plasma adsorption.
  
  
  METHODS
  Sixteen patients with acute liver failure each received a first session of treatment using the old system, in which plasma was perfused through an adsorber. They then received a second session using the new system, in which albumin-rich plasma separated using a fraction plasma separator was ultrafiltrated using a hemofilter and perfused through an adsorber before being returned to blood.
  
  
  RESULTS
  The new system had a higher clearance of bilirubin and slower decline of clearance over time. There was a lower reduction ratio of bilirubin, bile acid, urea, and creatinine; longer prolongation of coagulation parameters; and greater decline in albumin level using the old system compared with the new one.
  
  
  CONCLUSIONS
  Use of the novel system results in more efficient removal of toxins and fewer deterious effects than the old system.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Dehua
authors.initials: D
authors.lastname: Gong
authors.forename: Daxi
authors.initials: D
authors.lastname: Ji
authors.forename: Dongdong
authors.initials: D
authors.lastname: Zhu
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood*; D018481:Convection; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000097:blood / Q000378:metabolism / Q000628:therapy; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012709:Serum Albumin / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin; D001663:Bilirubin