Peritoneal Albumin Dialysis as a Novel Approach for Liver Support: Study in a Porcine Model of Acute Hepatic Failure.
Artificial liver support gained considerable interest in recent years due to the development of various albumin dialysis systems, which prolong survival of some patients with acute liver failure (ALF). Τhis study aims to examine the role of peritoneal albumin dialysis in a postoperative ALF model. ALF was induced in 14 female Landrace pigs by a combination of major liver resection (70-75% of total parenchyma) and ischemic-reperfusion injury on the liver remnant. Animals were randomly divided in two groups (n = 7 each). Both were monitored for 12 h of reperfusion and received peritoneal dialysis for 6 h, beginning 6 h after reperfusion. The albumin group received an albumin-rich solution and the control group received albumin-free solution. The control group gradually developed intracranial hypertension, whereas, in the albumin group, rise in the intracranial pressure was substantially attenuated (P < 0.01, t = 12 h). Albumin-treated animals had significantly lower levels of ammonia (P < 0.01), total bile acids (P < 0.01), free fatty acids (P < 0.05), lactate (P < 0.01), and total bilirubin (P < 0.05). Liver malondialdehyde and protein carbonyl were significantly reduced (P = 0.007 and P = 0.001 at t = 12 h) after albumin dialysis. Results suggest that this method may become a useful adjunct in the management of ALF, thus, justifying further study.
Experimental Surgical Unit, Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon Hospital.
Georgios
G
Defterevos
Department of Pathology, Medical School, National and Kapodistrian University of Athens.
Constantinos
C
Nastos
Experimental Surgical Unit, Second Department of Surgery, Medical School, National and Kapodistrian University of Athens, Aretaieion University Hospital.
Apostolos
A
Papalois
Experimental Surgical Unit, Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon Hospital.
Konstantinos
K
Kalimeris
Experimental Research Department, ELPEN-Pharma.
Vassileios
V
Margelos
Department of Pathology, Medical School, National and Kapodistrian University of Athens.
George
G
Fragulidis
Department of Nephrology, Evangelismos Hospital.
Agathi
A
Pafiti
Experimental Surgical Unit, Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon Hospital.
Aggeliki
A
Mikrovas
Department of Nutrition, Harokopeion University of Athens, Athens, Greece.
Tzortzis
T
Nomikos
Experimental Surgical Unit, Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon Hospital.
Vassilios
V
Smyrniotis
Experimental Surgical Unit, Fourth Department of Surgery, Medical School, National and Kapodistrian University of Athens, Attikon Hospital.
Nikolaos
N
Arkadopoulos
D000818:Animals; D005260:Female; D006439:Hemodynamics; D007427:Intracranial Pressure; D008099:Liver / Q000503:physiopathology; D017114:Liver Failure, Acute / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D018384:Oxidative Stress; D010530:Peritoneal Dialysis / Q000379:methods*; D015427:Reperfusion Injury / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D012709:Serum Albumin / Q000627:therapeutic use*; D013552:Swine
D012709:Serum Albumin
Liver ischemia/reperfusion injury; Major liver resection; Oxidative stress injury; Peritoneal albumin dialysis; Pringle's maneuver