Skip to main content
SpringerLink
Log in

Extracorporeal Non cellular Liver Assisted Devices

  • Chapter
  • First Online:
Liver Diseases

  • 2864 Accesses

Abstract

Liver Failure is associated with high mortality, whether it is an acute liver failure or acute decompensation on chronic liver disorder. Liver transplantation has been deemed to be a life saving procedure for end stages of liver failure. Due to high demand of liver grafts and limited availability there are instances where there is a need to bridge the gap until a graft is available. This chapter elaborates the currently available extracorporeal non cellular liver assist devices that includes Molecular adsorbent recirculating system (MARS), Prometheus—Fractionated plasma separation and adsorption system (FSPA), Single pass albumin dialysis (SPAD), and Selective plasma filtration therapy (SEPET) in an effort to support patients with end stages liver failure until a graft will become available or facilitate regeneration.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sleisenger MH, Feldman M, Friedman LS, et al. Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 9th ed. Philadelphia, PA: Saunders/Elsevier; 2010.

    Google Scholar 

  2. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1151–210.

    Article  Google Scholar 

  3. Puri P, Anand AC. Liver support devices. Med Update. 2012;22:489–93.

    Google Scholar 

  4. O’Grady J. Personal view: current role of artificial liver support devices. Aliment Pharmacol Ther. 2006;23:1549–57.

    Article  Google Scholar 

  5. Karvellas CJ, et al. Current evidence for extracorporeal liver support systems in acute liver failure and acute-on-chronic liver failure. Crit Care Clin. 2016;32(3):439–51.

    Article  Google Scholar 

  6. Strange J, Mitzner S, et al. Dialysis against a recycled albumin solution enables the removal of albumin-bound toxins. Artif Organs. 1993;17:809–13.

    Article  Google Scholar 

  7. Steiner C, Majacher-Peszynska J, Peszynski P, Teasdale D. MARS® liver support therapy. Therapy information for doctors and nurses. Teraklin AG. 2002;1:2.

    Google Scholar 

  8. Stange J, Mitzner S. A carrier-mediated transport of toxins in a hybrid membrane. Safety barrier between a patients blood and a bioartificial liver. Int J Artif Organs. 1996;19:677–91.

    Article  CAS  Google Scholar 

  9. Stange J, Mitzner SR, Risler T, Erley CM, Lauchart W, Goehl H, Klammt S, Peszynski P, Freytag J, Hickstein H, Lohr M, Liebe S, Schareck WP, Hopt UT, Schmidt R. Molecular adsorbent recycling system (MARS): clinical results of a new membrane-based blood purification system for bioartificial liver support. Artif Organs. 1999;23:319–30. https://doi.org/10.1046/j.1525-1594.1999.06122.x.

    Article  CAS  PubMed  Google Scholar 

  10. Mitzner SR, Stange J, Klammt S, Risler T, Erley CM, Bader BD, Berger ED, Lauchart W, Peszynksi P, Freytag J, Hickstein H, Loock J, Lohr JM, Liebe S, Emmrich J, Korten G, Schmidt R. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: results of a prospective, randomized, controlled clinical trial. Liver Transpl. 2000;6:277–86.

    Article  CAS  Google Scholar 

  11. Heeman U, Treichel U, Loock J, et al. Albumin dialysis in cirrhosis with superimposed acute liver injury: a prospective, controlled study. Hepatology. 2002;36:949–58.

    Article  Google Scholar 

  12. Banares R, Nevens F, Larsen FS, Jalan R, Albillos A, Dollinger M, et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial. Hepatology. 2013;57:1153–62.

    Article  CAS  Google Scholar 

  13. Saliba F, Camus C, Durand F, Mathurin P, Letierce A, Delafosse B, et al. Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure: a randomized, controlled trial. Ann Intern Med. 2013;159:522–31.

    Article  Google Scholar 

  14. Evenepoel P, Laleman W, Wilmer A, Claes K, Maes B, Kuypers D, Bammens B, Nevens F, Vanrenterghem Y. Detoxifying capacity and kinetics of prometheus-a new extracorporeal system for the treatment of liver failure. Blood Purif. 2005;23:349–58.

    Article  CAS  Google Scholar 

  15. Rifai K, Ernst T, Kretschmer U, Bahr MJ, Schneider A, Hafer C, Haller H, Manns MP, Fliser D. Prometheus-a new extracorporeal system for the treatment of liver failure. J Hepatol. 2003;39:984–90.

    Article  CAS  Google Scholar 

  16. Rifai K, Manns MP. Review article: clinical experience with Prometheus. Ther Apher Dial. 2006;10:132–7.

    Article  Google Scholar 

  17. Rifai K, Ernst T, Kretschmer U, Haller H, Manns MP, Fliser D. Removal selectivity of Prometheus: a new extracorporeal liver support device. World J Gastroenterol. 2006;12:940–4.

    Article  Google Scholar 

  18. Rifai K, Ernst T, Kretschmer U, Hafer C, Haller H, Manns MP, Fliser D. The Prometheus device for extracorporeal support of combined liver and renal failure. Blood Purif. 2005;23:298–302.

    Article  Google Scholar 

  19. Rifai K, Ernst T, Kretschmer U, et al. Prometheus - a new extracorporeal system for the treatment of liver failure. J Hepatol. 2003;39:984–90.

    Article  CAS  Google Scholar 

  20. Kribben A, Gerken G, Haag S, Herget-Rosenthal S, Treichel U, Betz C, et al. Effects of fractionated plasma separation and adsorption on survival in patients with acute-on-chronic liver failure. Gastroenterology. 2012;142(4):782–9.

    Article  CAS  Google Scholar 

  21. Chawla LS, Georgescu F, Abell B, Seneff MG, Kimmel PL. Modification of continuous venovenous hemodiafiltration with single-pass albumin dialysate allows for removal of serum bilirubin. Am J Kidney Dis. 2005;45:e51–6.

    Article  Google Scholar 

  22. Ringe H, Varnholt V, Zimmering M, Luck W, Gratopp A, Konig K, et al. Continuous veno-venous single-pass albumin hemodiafiltration in children with acute liver failure. Pediatr Crit Care Med. 2011;12(3):257–64.

    Article  Google Scholar 

  23. Piechota M, Piechota A. An evaluation of the usefulness of extracorporeal liver support techniques in patients hospitalized in the ICU for severe liver dysfunction secondary to alcoholic liver disease. Hepat Mon. 2016;16(7):e34127.

    Article  Google Scholar 

  24. Sponholz C, Matthes K, Rupp D, Backaus W, Klammt S, Karailieva D, et al. Molecular adsorbent recirculating system and single-pass albumin dialysis in liver failure–a prospective, randomised crossover study. Crit Care. 2016;20:2.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Rutgers—New Jersey Medical School, Newark, NJ, USA

    Mehul Shah & Nikolaos T. Pyrsopoulos

Authors
  1. Mehul Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikolaos T. Pyrsopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nikolaos T. Pyrsopoulos .

Editor information

Editors and Affiliations

  1. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Florentina Radu-Ionita

  2. New Jersey Medical School, Rutgers University New Jersey Medical School, Newark, NJ, USA

    Nikolaos T. Pyrsopoulos

  3. Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Mariana Jinga

  4. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Ion C. Tintoiu

  5. Medical Radiation Sciences, Curtin University, Perth, WA, Australia

    Zhonghua Sun

  6. “Prof. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

    Ecaterina Bontas

Self Study

Self Study

1.1 Questions

  1. 1.

    Which of the following is not an Extracorporeal Non Cellular Assisted Device?

    1. (a)

      Molecular Adsorbent Recirculating System (MARS™)

    2. (b)

      Extracorporeal Liver Assist Device (ELAD®)

    3. (c)

      Fractionated Plasma Separation and Adsorption System—FSPA (Prometheus™)

    4. (d)

      Single Pass Albumin Dialysis System (SPAD)

    5. (e)

      Selective plasma filtration therapy (SEPET)

  2. 2.

    Which of the following non cellular liver assisted devices have survival benefit?

    1. (a)

      Molecular Adsorbent Recirculating System (MARS™)

    2. (b)

      Fractionated Plasma Separation and Adsorption System—FSPA (Prometheus™)

    3. (c)

      Single Pass Albumin Dialysis System (SPAD)

    4. (d)

      Selective plasma filtration therapy (SEPET)

    5. (e)

      None of the above

1.2 Answers

  1. 1.

    Which of the following is not an Extracorporeal Non Cellular Assisted Device?

    1. (a)

      Molecular Adsorbent Recirculating System (MARS™). This is a non cellular liver assisted device.

    2. (b)

      CORRECT ANSWER. Extracorporeal Liver Assist Device (ELAD®). It is a bioartificial liver assist device.

    3. (c)

      Fractionated Plasma Separation and Adsorption System—FSPA (Prometheus™). This is a non cellular liver assisted device.

    4. (d)

      Single Pass Albumin Dialysis System (SPAD). This is a non cellular liver assisted device.

    5. (e)

      Selective plasma filtration therapy (SEPET). This is a non cellular liver assisted device.

  2. 2.

    Which of the following non cellular liver assisted devices have survival benefit?

    1. (a)

      Molecular Adsorbent Recirculating System (MARS™)

    2. (b)

      Fractionated Plasma Separation and Adsorption System—FSPA (Prometheus™)

    3. (c)

      Single Pass Albumin Dialysis System (SPAD)

    4. (d)

      Selective plasma filtration therapy (SEPET)

    5. (e)

      CORRECT ANSWER. None of the above

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shah, M., Pyrsopoulos, N.T. (2020). Extracorporeal Non cellular Liver Assisted Devices. In: Radu-Ionita, F., Pyrsopoulos, N., Jinga, M., Tintoiu, I., Sun, Z., Bontas, E. (eds) Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-24432-3_66

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24432-3_66

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24431-6

  • Online ISBN: 978-3-030-24432-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation