PMID- 16911318
OWN - NLM
STAT- MEDLINE
DCOM- 20061220
LR  - 20060816
IS  - 0160-564X (Print)
IS  - 0160-564X (Linking)
VI  - 30
IP  - 8
DP  - 2006 Aug
TI  - Plasma exchange-based plasma recycling dialysis system as a potential platform 
      for artificial liver support.
PG  - 629-33
AB  - We developed a plasma recycling dialysis (PRD) system based on plasma exchange 
      (PE). In this system, rapid reduction of toxic substances and restitution of 
      deficient essential substances are performed by PE, and subsequent blood 
      purification is performed by dialysis between separated plasma recycled over a 
      purification device and the patient's blood across the membrane of the plasma 
      separator. This study was performed to demonstrate the safety and efficacy of 
      this system. Hyperbilirubinemia was induced by ligating the bile duct in pigs, 
      and 7 days later, only PE for 2 h (group PE) or PE for 2 h followed by PRD for 6 
      h (group PE + PRD) was performed. The separated plasma was recycled over 
      anion-exchange resin through the extra fiber space of the plasma separator. The 
      safety and efficacy of this system were evaluated based on the values of 
      hemodynamic and laboratory parameters. Transfer from PE to PRD was completed in a 
      few minutes. The hemodynamic status and blood cells counts were stable and 
      hemolysis was not observed during the procedure. In the PE + PRD group, the 
      concentrations of total bile acids continuously decreased (pretreatment, 155.5 
      +/- 40.6 microM; 2 h [end of PE], 76.1 +/- 14.4 microM; 8 h [end of PRD], 25.8 
      +/- 9.1 microM) and the value was significantly lower than in the PE group after 
      6 h. The total bilirubin also continuously decreased during PRD (pretreatment, 
      55.3 +/- 11.5 microM; 2 h [end of PE], 33.8 +/- 8.4 microM; 8 h [end of PRD], 
      18.6 +/- 7.7 microM) and was significantly lower than in the PE group after 4 h. 
      No significant change was observed in other laboratory values. This PE-based PRD 
      system allowed a swift transfer from PE to sorbent-based blood purification. The 
      safety of this system was demonstrated and the removal of toxic substances was 
      significant. This study confirmed the clinical utility of this system as a 
      platform for artificial liver support.
FAU - Nishimura, Akimasa
AU  - Nishimura A
AD  - Department of Surgery, Hirosaki University School of Medicine, Hirosaki, Aomori, 
      Japan.
FAU - Umehara, Yutaka
AU  - Umehara Y
FAU - Umehara, Minoru
AU  - Umehara M
FAU - Hakamada, Kenichi
AU  - Hakamada K
FAU - Narumi, Shunji
AU  - Narumi S
FAU - Toyoki, Yoshikazu
AU  - Toyoki Y
FAU - Yoshihara, Shuichi
AU  - Yoshihara S
FAU - Sasaki, Mutsuo
AU  - Sasaki M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
RN  - 0 (Anion Exchange Resins)
SB  - IM
MH  - Animals
MH  - Anion Exchange Resins/*therapeutic use
MH  - Dialysis/*instrumentation
MH  - Female
MH  - Humans
MH  - Hyperbilirubinemia/therapy
MH  - Liver Failure/therapy
MH  - *Liver, Artificial
MH  - Plasma Exchange/*methods
MH  - Swine
EDAT- 2006/08/17 09:00
MHDA- 2006/12/21 09:00
CRDT- 2006/08/17 09:00
PHST- 2006/08/17 09:00 [pubmed]
PHST- 2006/12/21 09:00 [medline]
PHST- 2006/08/17 09:00 [entrez]
AID - AOR273 [pii]
AID - 10.1111/j.1525-1594.2006.00273.x [doi]
PST - ppublish
SO  - Artif Organs. 2006 Aug;30(8):629-33. doi: 10.1111/j.1525-1594.2006.00273.x.