Liver Support with Fractionated Plasma Separation and Adsorption and Prometheus®

  • K. Rifai
  • C. Tetta
  • C. Ronco
Conference paper


The liver performs multiple metabolic functions ranging from protein synthesis to gluconeogenesis, metabolism of amino acids, lipids and urea, and the detoxification of drugs and by-products of intermediate metabolism. The liver also acts in the regulation of the immune system and the metabolism of many hormones. As a consequence, liver insufficiency is catastrophic both at the metabolic and the clinical level, giving rise to a multiple organ failure (MOF) syndrome characterized by encephalopathy, jaundice, coagulopathy, and an imbalance of the immune system. At the same time, a multiplicity of toxic substances, both lipophylic and hydrophylic, are released into the systemic circulation, thus altering many enzymatic cellular processes. The lipophylic substances interfere with structural cellular processes, such as the reconstruction of cellular membranes, while the hydrophilic ones alter and block functional processes both enzymatic and non-enzymatic in nature.


Liver Failure Hepatic Encephalopathy Acute Liver Failure Liver Support Chronic Liver Failure 


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Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • K. Rifai
    • 1
  • C. Tetta
    • 2
  • C. Ronco
    • 3
  1. 1.Department of Gastroenterology, Hepatology, and EndocrinologyMedical SchoolHannoverGermany
  2. 2.International Research and DevelopmentFresenius Medical Care Deutschland GmbHBad HomburgGermany
  3. 3.Department of Nephrology, Dialysis and Renal TransplantationSan Bortolo HospitalVicenzaItaly

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