Efficacy of high-flow dialysate continuous hemodiafiltration in the treatment of fulminant hepatic failure

• Published in: Transfusion and apheresis science Vol. 40; no. 1; pp. 61 - 70
• Main Authors: Yokoi, Takehito, Oda, Shigeto, Shiga, Hidetoshi, Matsuda, Ken-ichi, Sadahiro, Tomohito, Nakamura, Masataka, Hirasawa, Hiroyuki
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2009
• Subjects: Adult; Artificial liver support; Coma - mortality; Coma - therapy; Disease-Free Survival; Female; Fulminant hepatic failure; Health technology assessment; Hematology, Oncology and Palliative Medicine; Hemodiafiltration - methods; Hepatic encephalopathy; High-flow dialysate continuous hemodiafiltration; Humans; Liver Failure, Acute - mortality; Liver Failure, Acute - therapy; Male; Middle Aged; Plasma exchange; Retrospective Studies; Slow plasma exchange plus continuous hemodiafiltration; Survival Rate; Plasma exchange; Artificial liver support; High-flow dialysate continuous hemodiafiltration; Slow plasma exchange plus continuous hemodiafiltration; Fulminant hepatic failure; Hepatic encephalopathy
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/j.transci.2008.11.006

Abstract We compared the clinical efficacy of high-flow dialysate continuous hemodiafiltration (HFCHDF) performed as artificial liver support (ALS) in fulminant hepatic failure (FHF) with those of conventional ALS techniques. Ninety patients were divided into non-HFCHDF and HFCHDF groups. Rate of recovery from coma was significantly higher in the HFCHDF group (70.2%) than in the non-HFCHDF group (44.2%) ( p < 0.01). The excellent recovery rate from coma achieved in patients with FHF by HFCHDF may be due to its enhanced capacity for liver support enabling efficient removal of substances causing hepatic coma from blood. HFCHDF should thus be useful for ALS.