Large-Pore Hemodialysis in Fulminant Hepatic Failure
In 50% of cases of fulminant hepatitis, brain death occurs (Nusinovici et al. 1977). Therefore maintenance of cerebral function is one of the main goals of an extracorporeal liver assist. Previous work in this laboratory showed that hemodialysis with high permeability polyacrylonitrile membrane (AN 69, Rhone Poulenc, Paris, France) allowed neurological and electroencephalogram (EEG) enhancement in 60% of comatose animals after acute liver ischemia (Opolon et al. 1976 a). Comparative hemodialysis with low-permeability Cuprophan membrane was followed by faster neurological and EEG deterioration and shorter survival (Opolon et al. 1976 a). These results led to simultaneous development of: (a) an experimental program to investigate brain neurotransmitters and amino acid transfer under such conditions; (b) a clinical trial of AN 69 hemodialysis for the treatment of liver coma in patients with fulminant hepatitis. Preliminary results have been published (Opolon et al. 1976 b) and the experimental part of this work has also been completed and published (Bloch et al. 1978).
KeywordsBrain Death Fulminant Hepatic Failure Fulminant Hepatitis Hepatic Coma Liver Coma
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