急性肝不全

概要

論文の詳細を見る
Acute liver failure (ALF) is considered to be the rapid deterioration of hepatic function manifested by jaundice (bilirubin >__= 5 mg/dl) and encephalopathy (Glasgow coma score <__= 12) or coagulopathy (prothrombin time acstivity <__= 40%) within 8 weeks from the first symptoms. In Japan, the most common cause of ALF is viral hepatitis, followed by ischemia due to operation or trauma. Less common cause of ALF include poisoning and sepsis. In the treatment of ALF, detoxification with nonbiological artificial liver support systems such as hemoperfusion or hemodiafiltration (HDF) alone could not improve survival rates, despite a moderate incidence of recovery of consciousness. Therefore, the development of devices using biomaterials has been attempted to overcome this limitation by adding metabolic support such as plasma exchange (PE) or hybrid artificial liver. Indeed, a combination of PE and HDF using high-performance membranes was applied for 35 patients diagnosed with fulminant viral hepatitis within 4 weeks from onset. The survival rates were 65% for acute type and 50% for subacute type, although there was a high incidence of recovery of consciousness. In the near future, this rate will be improved by new extra-corporeal liver assist devices using human hepatoblastoma cells, which have both detoxifying and synthetic functions.
日本アフェレシス学会の論文
1999-02-28