Liver support devices

@article{Phua2008LiverSD,
  title={Liver support devices},
  author={Jason Phua and Kang Hoe Lee},
  journal={Current Opinion in Critical Care},
  year={2008},
  volume={14},
  pages={208–215}
}
  • J. Phua, K. Lee
  • Published 1 April 2008
  • Medicine
  • Current Opinion in Critical Care
Purpose of reviewLiver support devices are used either as a bridge to liver transplantation or liver recovery in patients with acute or acute-on-chronic liver failure. The review analyzes the recent literature and asks if the current enthusiasm for these devices is justified. Recent findingsMany liver support devices exist and are discussed. Clinical data on artificial devices are rapidly emerging, especially on the molecular adsorbents recirculating system, and fractionated plasma separation… 
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There is ongoing research to restore liver function in cell biology, animal models and clinical trials using mature hepatocytes, liver progenitor cells, mesenchymal stem cells and embryonic stem cells.
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References

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TLDR
The Hepatix ELAD is safe, and it provides measurable metabolic support in patients with late-stage liver failure, and this pilot study provides the impetus to perform controlled trials of ELAD therapy in the treatment of various types of end- stage liver disease.
Artificial and bioartificial liver devices: present and future
TLDR
The operating principles, chemical effects, clinical effects and complications of both types of artificial livers are reviewed, with specific attention paid to bioartificial systems.
Technology Insight: artificial extracorporeal liver support—how does Prometheus® compare with MARS®?
TLDR
A large randomized controlled trial investigating the effect of Prometheus® on survival—the HELIOS study—has been initiated and will be crucial to establishing a role for Prometheus® in the field of extracorporeal liver support.
Initial experience with the modified extracorporeal liver-assist device for patients with fulminant hepatic failure: system modifications and clinical impact
TLDR
The patients tolerated treatment with the ELAD well, and the results from this single-institution experience indicates that larger randomized multicenter trials should proceed.
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TLDR
Prompt liver detoxification was supported by a significant decrease of serum levels of conjugated bilirubin, bile acids and ammonia, and Prometheus is a safe treatment for patients with HRS.
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TLDR
ALSS appears to be efficacious and safe for the treatment of patients with AoCLF and both model for end-stage liver disease (MELD) score and hepatic encephalopathy are useful to predict the mortality of patients.
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TLDR
TECA-HALSS treatment could be a rapid, safe and efficacious method to provide temporary liver support for patients with acute liver failure.
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TLDR
Prometheus is a safe supportive therapy for patients with liver failure and a significant improvement of the biochemical milieu was observed already after two treatments, and Prospective controlled studies are necessary to evaluate hard clinical end-points.
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TLDR
This Review indicates that artificial support systems may reduce mortality in acute-on-chronic liver failure, and considering the strength of the evidence additional randomised clinical trials are needed before any support system can be recommended for routine use.
Pilot‐controlled trial of the extracorporeal liver assist device in acute liver failure
TLDR
Assessment of additive function for the device revealed an improvement in galactose elimination capacity after 6 hours of haemoperfusion, and better indices of prognosis will be required, in addition to those used to select for transplantation, if patients at an earlier stage of clinical deterioration are to be included in future studies.
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