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Prometheus – a new therapeutic option in liver failure in children


Authors: Hladík Michal 1,2;  Zaoral Tomáš 1;  Čáp Jiří 3
Authors‘ workplace: Klinika dětského lékařství Fakultní nemocnice Ostrava 1;  Fakulta zdravotních studií, Ostravská univerzita, Ostrava 2;  Klinika anesteziologie, resuscitace a intenzivní péče, Transplantcentrum, IKEM 3
Published in: Anest. intenziv. Med., 21, 2010, č. 4, s. 207-212
Category: Case Report

Overview

Acute liver failure is a rare but potentially fatal condition with mortality reaching 80–90 %. Dialysis, haemoperfusion and countinuous renal replacement therapy are currently the methods of choice in patients with this critical condition.

Prometheus has been recently introduced in our PICU. This liver replacement device is designed to eliminate toxins produced during the liver failure state. So far two critically ill children – aged 7 years and 15 months – have been treated with Prometheus. Although unfortunately both the patients died of brain oedema, we witnessed a good elimination efficiency of the system. Ideal timing of the initiation of the therapy appears to be a crucial factor.

Keywords:
acute liver failure – child – critical state – Prometheus – King’College Criteria


Sources

1. Thompson, A. E. Liver Failure in Infants and Children. p. 1027–1039. In: Wheeler, D. S., Wong, H. R., Shanley, T. P. (eds.) Pediatric Critical Care Medicine-Basic Science and Clinical Evidence. Springen.Verlag London, 2007, 1805 s.

2. Rifai, K., Ernst, T., Kreschmer, U., Bahr, M. J., Schneider, A., Hafer, C., Haller, H., Manns, M. P., Fliser, D. Prometheus – a new extracorporeal systém for the treatment of liver failure. J. Hepatol., 2003, 39, 6, p. 984–990.

3. Evenepoel, P., Laleman,W., Wilmer, A., Claes, K., Maes, B., Kuypers, D., Bammens, B., Nevens, F.,Vanrenterghem,Y. Detoxyfiing Capacity and Kinetics of Prometheus – A New Extracorporeal System for the Treatment of Liver Failure. Blood Purif, 2005, 23, p. 349–358.

4. Falkenhagen, D., Strobl, W., Vogt, G., Schrefl, A., Linsberger, I., Gerner, F. J. Fractionated plasma separation and adsorption system: a novel system for blood purification to remove albumin bound substances. Artif. Organs, 1999, 23, p. 81–86.

5. Kjaergard, L. L., Liu, J., Als-Nielsen, B., Gluud, C. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure. JAMA, 2003, 289, p. 217–222.

6. Bailey, B., Amre, D., Gaudreault, P. Fulminant hepatic failure secondary to acetaminophen poisoning: a systematic review and meta-analysis of prognostic criteria determining the need for liver transplantation. Crit. Care Med., 2003, 31, 1, p. 299–305.

7. Anand, A., Nightingale, P., Neuberger, J. Early indicators of prognosis in fulminant hepatic failure: an assessment of the King’s criteria. J. Hepatol., 1997, 26, 1, p. 62–68.

8. Shakil, A., Kramer, D., Mazariegos, G., Fung, J., Rakela, J. Acute liver failure: clinical features, outcome analysis, and applicability of prognostic criteria. Liver Transpl., 2000, 6, 2, p. 163–169.

9. Enjalbert, F., Rapior, S. et al. Treatment of Amatoxin Poisoning – 20-Year Retrospective analysis. Journal of toxicology, 2002, 40, 6, p. 715–757.

10. Broussard, C. N., Aggarwal, A., Lacey, S. R. et al. Mushroom poisoning – from diarrhea to liver transplantation. Am. J. Gastroenterol., 2001, 96, p. 3195–3198.

11. Soysal, D., Çevik, C., Saklamaz, A., Yetimalar, Y., Ünsal, B. Coagulation disorders secondary to acute liver failure in Amanita phalloides poisoning. The Turkish Journal of Gastroenterology, 2006, 17, p. 198–200.

12. Kramer, L., Bauer, E., Schenk, P. et al. Successful treatment of refractory cerebral oedema in ectasy/cocaine-induced fulminant hepatic failure using a new high-efficacy liver detoxification device (FPSA-Prometheus). Wien Klin. Wochenschr., 2003, 115, p. 559–603.

13. Marcus, K. H., Kim, H. S., Beste, M. Removal of Metabolites, Cytokines and Hepatic Growth Factors by Extracorporeal Liver Support in Children. Journal of Pediatric Gastroenterology and Nutrition, 2005, 40, p. 54–55.

14. Kieslichová, E., Ročeň, M., Trunečka, P., Janoušek, L., Šperl, J., Petrášek, J., Vítko, Š. Úspěšná léčba akutního renálního selhání jater pomocí přístrojové podpůrné terapie s následnou transplantací jater. Prakt. Lék., 2006, 86, 5, p. 275–277.

15. Lee, W. Liver Failure and Liver Support. Seminars in Liver Disease. 2008, 28, 2, p. 135–136.

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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