術後肝不全に対するプラスマフェレシス(<特集>肝・膵疾患とアフェレシス)

概要

論文の詳細を見る
To support and treat postoperative hepatic failure patients, the supply of the efficient substances and removal of excess toxic substances are required. Bleeding and infection are the major complications and causes of death of postoperative hepatic failure patients. The administra- tion of fresh frozen plasma supplies coagulation factors and reduces the bleeding tendency. Plasma exchange is useful to supply many of the coagulation factors and other deficient substances. But in patients with bleeding or bleeding tendency, it is always dangerous to use heparin because of the risk of hemorrhage after treatment. We have applied nafamostat mesilate, a synthetic protease inhibitor, to clinical plasmapheresis as a regional anticoagulant. The administration of concen- trated antithrombin III(AT-III)was effective in the treatment of hepatic failure. Hemofiltration with high-performance membrane for the treatment of hepatic failure is better in removal capacity and more effective than plasma exchange alone. PMX that can adsorb endotoxin from the circulation has been used for infection which is the most important negative factor in the treatment of hepatic failure. Blood purification for postoperative hepatic failure is evaluated as a main therapeutic procedure.
日本アフェレシス学会の論文
1997-10-31