アルブミン透析 : Extracorporeal albumin dialysis(ECAD)(<特集>アフェレシス療法における新しいmodality)
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概要
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The recent development of a thin dialysis membrane with a large pore size (high-flux membrane) has made it possible to remove middle molecular weight substances and even some low molecular weight protein fractions. However, even using these high-flux membranes, small molecular weight substances that are strongly bound to albumin, such as indoxyl sulfate and bilirubin, are not adequately removed by conventional dialysis techniques. Albumin has the ability to bind with multiple molecules, albumin containing bicarbonate dialysate (albumin dialysate; AD) was applied to dialysis, and this dialysis with AD has been developed as the new blood purification technology. This blood purification technology is named extracorporeal albumin dialysis (ECAD). Some methods based on the concept of ECAD have been reported such as Molecular Adsorption Recycling System (MARS^[○!R]), Prometheus^[○!R], and Continuous Albumin Purification System (CAPS). ECAD is defined as the following: ECAD is the therapy using an extracorporeal method and AD for removal of not only water-soluble toxins but also ABT. The most important target of ECAD is the recovery of the essential function of albumin as carrier protein, antioxidant, and buffer. MARS removes many toxic substances including ABT, and has beneficial effects on brain, liver, renal, and cardiovascular dysfunctions; improvement of 30-day survival was reported. ECAD may become a possible therapeutic tool in patients with liver failure.
- 2009-10-31
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