Pilot‐controlled trial of the extracorporeal liver assist device in acute liver failure

@article{Ellis1996PilotcontrolledTO,
  title={Pilot‐controlled trial of the extracorporeal liver assist device in acute liver failure},
  author={A. J. Ellis and Robin D. Hughes and Julia A. Wendon and J. Dunne and Peter G. Langley and James H. Kelly and Gardar Gislason and Norman Leslie Sussman and R. Williams},
  journal={Hepatology},
  year={1996},
  volume={24}
}
The objective of this pilot controlled study was to evaluate the extracorporeal liver assist device (ELAD) in patients with acute liver failure who were judged to still have a significant chance of survival (approximately 50%) and in those who had already fulfilled criteria for transplantation. Twenty‐four patients were divided into two groups, 17 with a potentially recoverable lesion (group I) and 7 listed for transplantation (group II), and then randomly allocated to ELAD haemoperfusion or… 
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.
An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
TLDR
Significantly lower intensive care unit (ICU) mortality and 30-day mortality rates were found in the SMT + ECLS subgroup, and the best discriminatory power was shown for the SAPS II score, followed by SOFA, APACHE II, MELD UNOS and GCS scores.
Prospective, Randomized, Multicenter, Controlled Trial of a Bioartificial Liver in Treating Acute Liver Failure
TLDR
This is the first prospective, randomized, controlled trial of an extracorporeal liver support system, demonstrating safety and improved survival in patients with fulminant/subfulminant hepatic failure.
PROSPECTS FOR EXTRACORPOREAL LIVER SUPPORT
This present review is timely with the increasing use of the molecular adsorbents recirculating system (MARS) for the management of liver failure, with over 3000 patients having been treated with
Extracorporeal liver support
TLDR
The future development of liver support systems may provide different combinations of new adsorbents, integrated regional citrate anticoagulation and eventual substitution of irreversibly damaged albumin.
Systematic review: extracorporeal bio-artificial liver-support system for liver failure
TLDR
Although BAL system proved to be a success in some clinical cases reported, it still needs to be improved greatly.
Efficacy of an extracorporeal flat-plate bioartificial liver in treating fulminant hepatic failure.
TLDR
A flat-plate BAL with an internal membrane oxygenator and cultured porcine hepatocytes has yielded encouraging results in the treatment of rats with GalN-induced FHF.
Extracorporeal liver support with molecular adsorbents recirculating system in patients with severe acute alcoholic hepatitis.
TLDR
MARS resulted in improved liver biochemistry, cardiovascular haemodynamics, renal function and encephalopathy in patients with severe AH, with an apparent reduction in mortality, and a multi-centre, randomized clinical trial is initiated.
Artificial liver support systems
Despite recent advances in medical therapy, patients with fulminant hepatic failure (FHF) have a mortality rate approaching 90%. Many patients die because of failure to arrest the progression of
Comparison of extracorporeal cellular therapy (ELAD®) vs standard of care in a randomized controlled clinical trial in treating Chinese subjects with acute-on-chronic liver failure
TLDR
ELAD treatment was well tolerated by Chinese subjects with ACLF, predominately secondary to chronic viral hepatitis and demonstrated a significant improvement in TFS in ELAD vs control groups in association with significant improvements in serum bilirubin levels presumably related to improvement in hepatic function.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 21 REFERENCES
The Hepatix extracorporeal liver assist device: initial clinical experience.
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.
Assessment of an extracorporeal liver assist device in anhepatic dogs.
TLDR
An anhepatic dog model is used to demonstrate the efficacy of a bioartificial liver assist device capable of replacing the metabolic function of the liver, and might provide hepatic support in patients awaiting transplantation or in fulminant hepatic failure.
Reversal of fulminant hepatic failure using an extracorporeal liver assist device
TLDR
A device consisting of a highly differentiated human liver cell line cultured in a hollow fiber cartridge is capable of supporting dogs with acetaminopheninduced fulminant hepatic failure for a period long enough for their own livers to resume function, allowing recovery of hepatocytes that would otherwise have lysed.
A Bioartificial Liver to Treat Severe Acute Liver Failure
TLDR
The bioartificial liver developed by the authors is safe and serves as an effective “bridge” to liver transplant in some patients and in vivo in experimental animals with liver failure.
Early indicators of prognosis in fulminant hepatic failure.
The successful use of orthotopic liver transplantation in fulminant hepatic failure has created a need for early prognostic indicators to select the patients most likely to benefit at a time when
Extracorporeal liver assist in the treatment of fulminant hepatic failure.
TLDR
The initial results suggest that 20% of the normal hepatocyte mass is an appropriate number, and a clinical trial to determine safety and efficacy is under way at the Texas Medical Center.
Heparin response and clearance in acute and chronic liver disease.
TLDR
Hparin kinetics in patients with fulminant hepatic failure after a single intravenous dose of heparin is investigated and it is found there was an increased clearance and an increased sensitivity to heParin.
A treatment system for implementing an extracorporeal liver assist device.
TLDR
It is concluded that currently available extracorporeal blood treatment systems are not suited to the delivery of high molecular weight substances and that they do not adequately address the metabolic needs of the device.
A case of syncytial giant-cell hepatitis treated with an extracorporeal liver assist device.
TLDR
The patient recovered slowly from her multisystem disease and was discharged with mildly elevated transaminases and biochemical evidence of cholestasis, and the patient appears to have no sequelae of her disease.
Effect of ELAD Liver Support on Plasma HGF and TGF–β1 in Acute Liver Failure
The aim of this study was to investigate the effects of treatment with the extracorporeal liver assist device (ELAD) in patients with acute liver failure (ALF) on plasma hepatocyte growth factor
...
1
2
3
...