Background & Aims
Extracorporeal blood purification systems for supportive therapy of liver failure
are widely used. We developed a novel blood purification system, named Li’s artificial
liver system (Li-ALS), which couples low-volume plasma exchange (low-volume PE) with
plasma filtration adsorption (PFA). This study aims to evaluate the efficacy of our
novel system in pigs with acute liver failure (ALF).
Methods
Thirty-two pigs were infused with D-galactosamine (1.3 g/kg) to induce ALF. All animals were equally and randomly divided into four groups:
the ALF control group received intensive care, the PFA group underwent five hour plasma
recycling filtration and adsorption purification, the low-volume PE group received
one hour low-volume PE, and the Li-ALS group underwent one hour low-volume PE, followed
by five hour PFA. Intervention was initiated 36 hours after drug administration. The efficacy of each treatment was assessed by survival
time and improvement in hematological, biochemical, and immunohistological parameters.
Results
Pigs in the Li-ALS group survived longer than those in the other groups (p <0.001, ALF control: 60 ± 2 h; PFA group: 74 ± 2 h; low-volume PE group: 75 ± 2 h; and Li-ALS group: 90 ± 3 h). Liver enzyme, bilirubin, bile acid and blood ammonia levels were decreased significantly
after Li-ALS treatment, and increases in inflammatory cytokines were ameliorated.
A higher hepatocyte regeneration index was also observed in the Li-ALS group.
Conclusion
Our novel Li-ALS could expedite liver regeneration and improve survival time; hence,
it could be promising for treating ALF.
Graphical abstract
Graphical Abstract
Abbreviations:
ALS (Artificial liver system), ALT (Alanine aminotransferase), AST (Aspartate aminotransferase), HCT (Hematocrit), MARS (Molecular adsorbent and recirculating system), PE (Plasma exchange), PFA (Plasma filtration adsorption), HGF (hepatocyte growth factor), TNF-α (Tumour necrosis factor-α), TGF-β1 (Transforming growth factor-β1), Ang-II (Angiotensin-II), LPC (Liver progenitor cell)Keywords
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Article info
Publication history
Published online: March 24, 2015
Accepted:
March 14,
2015
Received in revised form:
March 13,
2015
Received:
November 18,
2014
See Editorial, pages 303–305Identification
Copyright
© 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
