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Article: Selective plasma filtration for treatment of fulminant hepatic failure induced by D-galactosamine in a pig model

TitleSelective plasma filtration for treatment of fulminant hepatic failure induced by D-galactosamine in a pig model
Authors
Issue Date2002
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation
Gut, 2002, v. 50 n. 6, p. 869-876 How to Cite?
AbstractBackground: Plasma exchange may be useful for treating patients with fulminant hepatic failure but during the procedure growth factors that are important for hepatic regeneration are discarded. Addition of a selective plasma filter to the plasmapheresis circuit could eliminate protein bound toxic substances and retain growth factors for hepatic regeneration. This process is called selective plasma filtration. Aims: To determine if selective plasma filtration could be a useful treatment modality for fulminant hepatic failure. Methods: The system was tested in five groups of pigs with fulminant hepatic failure induced by galactosamine: group I, diseased control group (n=5); group II, sham control, (n=6); group III, plasma exchange (n=6); group IV, treatment with AC-1770 selective plasma filter (n=7); and group V, treatment with AC-1730 selective plasma filter which had a smaller pore size than AC-1770 (n=7). Fresh pig plasma was given to replace filtered plasma in pigs of groups III, IV, and V. Treatment was initiated 48 hours after administration of 0.75 g/kg galactosamine. The efficacy of selective plasma filtration was assessed by survival rate and improvement in haematological, biochemical, and immunohistological parameters. Results: Pigs treated with AC-1770 or AC-1730 selective plasma filters survived longer than the other groups (group I: 55 (10) hours; group II: 68 (7) hours; group III: 91 (10) hours; group IV: 269 (156) hours; group V: 950 (555) hours). One pig in group IV survived for 50 days; one pig in group V survived for 77 days and another pig in group V is still alive (>150 days). After treatment, plasma levels of aspartate aminotransferase, bilirubin, bile acid, ammonia, lactate dehydrogenase, and α-glutathione-S-transferase decreased. Substantial amounts of tumour necrosis factor α (TNF-α) and endotoxin were found in the filtrate. The selective plasma filtration groups retained significantly higher amounts of hepatocyte growth factor than plasma exchange alone. Similar TNF-α clearance was observed in the selective plasma filtration groups and the plasma exchange group. On day 4, significant improvement in liver function, as measured by the indocyanine green clearance test, was observed in groups IV and V but not in the other groups. A higher regeneration index of hepatocytes was also observed in the groups treated with AC-1770 and AC-1730 selective plasma filters. Conclusion: Selective plasma filtration improved survival time and expedited liver regeneration in pigs with fulminant hepatic failure.
Persistent Identifierhttp://hdl.handle.net/10722/43511
ISSN
2015 Impact Factor: 14.921
2015 SCImago Journal Rankings: 6.474
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, DWYen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorTo, Jen_HK
dc.contributor.authorWoo, YHen_HK
dc.contributor.authorZhang, Zen_HK
dc.contributor.authorLau, Cen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2007-03-23T04:47:35Z-
dc.date.available2007-03-23T04:47:35Z-
dc.date.issued2002en_HK
dc.identifier.citationGut, 2002, v. 50 n. 6, p. 869-876en_HK
dc.identifier.issn0017-5749en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43511-
dc.description.abstractBackground: Plasma exchange may be useful for treating patients with fulminant hepatic failure but during the procedure growth factors that are important for hepatic regeneration are discarded. Addition of a selective plasma filter to the plasmapheresis circuit could eliminate protein bound toxic substances and retain growth factors for hepatic regeneration. This process is called selective plasma filtration. Aims: To determine if selective plasma filtration could be a useful treatment modality for fulminant hepatic failure. Methods: The system was tested in five groups of pigs with fulminant hepatic failure induced by galactosamine: group I, diseased control group (n=5); group II, sham control, (n=6); group III, plasma exchange (n=6); group IV, treatment with AC-1770 selective plasma filter (n=7); and group V, treatment with AC-1730 selective plasma filter which had a smaller pore size than AC-1770 (n=7). Fresh pig plasma was given to replace filtered plasma in pigs of groups III, IV, and V. Treatment was initiated 48 hours after administration of 0.75 g/kg galactosamine. The efficacy of selective plasma filtration was assessed by survival rate and improvement in haematological, biochemical, and immunohistological parameters. Results: Pigs treated with AC-1770 or AC-1730 selective plasma filters survived longer than the other groups (group I: 55 (10) hours; group II: 68 (7) hours; group III: 91 (10) hours; group IV: 269 (156) hours; group V: 950 (555) hours). One pig in group IV survived for 50 days; one pig in group V survived for 77 days and another pig in group V is still alive (>150 days). After treatment, plasma levels of aspartate aminotransferase, bilirubin, bile acid, ammonia, lactate dehydrogenase, and α-glutathione-S-transferase decreased. Substantial amounts of tumour necrosis factor α (TNF-α) and endotoxin were found in the filtrate. The selective plasma filtration groups retained significantly higher amounts of hepatocyte growth factor than plasma exchange alone. Similar TNF-α clearance was observed in the selective plasma filtration groups and the plasma exchange group. On day 4, significant improvement in liver function, as measured by the indocyanine green clearance test, was observed in groups IV and V but not in the other groups. A higher regeneration index of hepatocytes was also observed in the groups treated with AC-1770 and AC-1730 selective plasma filters. Conclusion: Selective plasma filtration improved survival time and expedited liver regeneration in pigs with fulminant hepatic failure.en_HK
dc.format.extent267467 bytes-
dc.format.extent27648 bytes-
dc.format.extent454989 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/en_HK
dc.relation.ispartofGuten_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsGut. Copyright © B M J Publishing Group.en_HK
dc.subject.meshGalactosamine - adverse effectsen_HK
dc.subject.meshLiver failure - chemically induced - pathology - therapyen_HK
dc.subject.meshPlasma exchange - methodsen_HK
dc.subject.meshTumor necrosis factor-alpha - metabolismen_HK
dc.subject.meshPlasmapheresis - methodsen_HK
dc.titleSelective plasma filtration for treatment of fulminant hepatic failure induced by D-galactosamine in a pig modelen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0017-5749&volume=50&issue=6&spage=869&epage=876&date=2002&atitle=Selective+plasma+filtration+for+treatment+of+fulminant+hepatic+failure+induced+by+D-galactosamine+in+a+pig+modelen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1136/gut.50.6.869en_HK
dc.identifier.pmid12010892-
dc.identifier.pmcidPMC1773226-
dc.identifier.scopuseid_2-s2.0-0036115581en_HK
dc.identifier.hkuros69051-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036115581&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume50en_HK
dc.identifier.issue6en_HK
dc.identifier.spage869en_HK
dc.identifier.epage876en_HK
dc.identifier.isiWOS:000175812200024-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridHo, DWY=7402971906en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridTo, J=6603618643en_HK
dc.identifier.scopusauthoridWoo, YH=38762365200en_HK
dc.identifier.scopusauthoridZhang, Z=8574700400en_HK
dc.identifier.scopusauthoridLau, C=8086563300en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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