Clinical selection of individualizd artificial liver support / 中华临床感染病杂志

ABSTRACT

Liver failure is characterized by hepatic encephalopathy, jaundice, hypo-coagulation and high mortality.Artificial liver support aims to temporarily replace hepatic function until liver function recover or bridge to liver transplantation.Individualized artificial liver support should be balanced and cover the following aspects removing albumin bound toxins and/or water soluble toxins, eliminating inflammatory mediators and correcting blood coagulation disorders, in order to support metabolism and modulate immune function and to promote the regeneration of hepatocyte and reverse multiple organ failure that may lead to death of patients.Traditional non-biological artificial liver support can't meet individualized treatment.Recently developed hybrid blood purification model, such as albumin dialysis, fractionated plasma separation and adsorption (Prometheus system) and plasma diafiltration (PDF) have provided more and better choices for individualized artificial liver support.Based on the characteristics of pathophysiology and organ dysfunction of liver failure, the author has designed an alignment diagram of individualized artificial liver support for clinical selection.