重症肝障害におけるPlasma Dia-filtration(PDF)-Plasma Filtration with Dialysis-療法(<特集>急性臓器障害に対するアフェレシス)

概要

論文の詳細を見る
Liver failure sometimes develops to be fatal. Temporary control of liver failure, including artificial liver support (ALS), can widen the therapeutic window and improve the status of patient with liver failure. In Japan, plasma exchange plus continuous hemodiafiltration has been performed as a strategy for ALS. We report here a novel plasmapheresis, Plasma Dia-filtration (PDF), based on the concept of plasma filtration with dialysis. PDF is performed with the membrane plasma separator "Evacure" (type : EC-2 A 10) (Kuraray Medical Inc., Tokyo, Japan) and the post-dilution CHDF flow diagram. As dialysate, Sublood-BS (Fuso Pharmaceutical Industries, Ltd., Osaka, Japan) was prepared, and for substitute liquid, FFP 15 units followed by 25% albumin solution 50ml were used for 8 hours as one session. Seven patients with hepatic insufficiency were enrolled and underwent 43 sessions of PDF in total. The average±SE of serum total bilirubin were 12.0±0.2mg/dl and 8.7±0.7mg/dl, before and after the PDF, respectively, with significant reduction (p<0.01). We calculated the clearance of T. Bil, IL-6, IL-8, BUN and Cre at one hour after the start of the PDF procedure (QB; 80ml/min, QF; 10ml/min, QD; 10ml/ min). The clearances (ml/min) were 5.6, 18.1, 18.8, 18.4 and 21.5, respectively. In our multicenter analysis, 32 patients with liver failure were enrolled treated with PDF, and their mortality rate was 47%. PDF is a simple modality and may develop to become a useful strategy for treatment of patients with liver failure.
2007-10-31

重症肝障害におけるPlasma Dia-filtration(PDF)-Plasma Filtration with Dialysis-療法(<特集>急性臓器障害に対するアフェレシス)

スポンサーリンク

概要

著者

関連論文

スポンサーリンク