肝不全治療に対する人工肝補助療法

概要

論文の詳細を見る
Acute liver failure (ALF), especially fulminant hepatitis (FH), is a severely critical disease due to its high mortality (acute type: about 50%, sub-acute type: about 75% in Japan, without liver transplantation). Blood purification such as plasma exchange (PE), hemodiafiltration (HDF), continuous hemodiafiltration (CHDF), cryofiltration (Cryo), and bilirubin adsorption (BA) is applied for the patients with liver failure as an artificial liver support system (ALS). The most useful treatment is the combination of PE and HDF or CHDF. Moreover, the introduction of high flow CHDF for the patient with FH improves the recovery rate of hepatic encephalopathy. We treated 98 cases of ALF. Of 98 patients, 34 cases were fulminant hepatitis, 20 cases were postoperative liver failure, 8 cases were serious hepatitis, 8 cases were drug-induced hepatitis and 28 cases were other diseases. The survival rate were 38.2%, 0%, 62.5%, 37.5% and 10.7%, respectively. The efficacy of ALS is sometimes limited now. We should discuss the strategy of applying liver transplantation during ALS treatment. However, the consequences of ALS using blood purification system will persist even after performing liver transplantation.
2008-10-31