肝脏透析 正在崛起

liver411

一个可以帮助患者延长生命, 给医生时间寻找新肝脏的肝脏透析技术正在崛起.
这个透析通常被医生叫做"白蛋白透析". 是密西跟大学研究人员根据肾脏透析原理研制出来的一个装置, 即把血液抽出体外, 有毒物质被清除, 再将健康的血液输回体内. 目前可以充当一个肝脏衰竭和肝脏移植间的桥梁.

心脏不行可以体外循环修补, 肾脏不好可以透析, 肺不好我们也有药物和机器抢救, 但是因为肝炎, 肝硬化, 肝脏药物/化学性中毒的肝脏衰竭, 往往是突发的, 医生们却束手无策, 只能治疗肝脏衰竭造成的合并症, 是许多生命因此而丧生或死在移植的排名上. 这个仪器可以作为第一个帮助医生解决这个问题的方法.

仪器的简单原理是, 将血液通过一个白蛋白的装置, 因为白蛋白是传送药物, 毒素...许许多多作用, 当肝脏衰竭时/功能不好时其代谢蛋白失调..., 当血液通过蛋白时, 蛋白将毒素"抓住", 干净血再流回体内.

目前欧洲已经批准使用, 但是FDA还需要进一步临床试验, 估计三年后才能在美国应用. 而且进一步的改进也在过程中.

附带原文:

Liver dialysis on horizon

September 6, 2002

A new liver dialysis procedure may help critically ill patients survive long enough to get a liver transplant.
Known as albumin dialysis, University of Michigan researchers say the system works in a manner similar to kidney dialysis: blood is removed from the body, toxic substances are filtered out, and healthy blood is returned to the body.

[B]First mechanical device to help liver failure patients[/B]

"For the first time, there is a mechanical device that can help people with liver failure," says researcher Dr. Robert Bartlett, a professor of surgery at the University of Michigan. "[Albumin dialysis] is a bridge to liver transplantation. It stabilises the patient so they can wait for a donor."

Bartlett and other researchers will be discussing their latest findings at the Fourth International Symposium on Albumin Dialysis in Liver Disease in Rostock, Germany.

[B]Currently no treatment of failure[/B]

Livers fail for a variety of reasons. Cirrhosis, hepatitis and chemical toxins are the most common causes of liver failure, according to Bartlett.

The liver performs many important functions, including aiding in digestion, storing vitamins and other nutrients, breaking down and removing toxic substances, and regulating blood clotting. Currently, when the liver fails, there is no treatment other than to try to control the symptoms, such as jaundice or fluid retention, or to perform a liver transplant.

"It's been quite frustrating," explains Dr Stuart Gordon, chairman of gastroenterology and hepatology at William Beaumont Hospital in Michigan, USA.

"We can assist with almost every other end-stage form of disease. When kidneys fail, we have dialysis. We have drugs and machines to help when the heart fails and when the lungs fail. But we don't have medications or devices to do the functions of the liver," he says.

That's why this device appears to be the "beginning of a dream," he says, although he cautions that the latest work is just a first step. He says the next step is a randomised controlled trial, which is exactly what Bartlett and his colleagues are undertaking, beginning in early 2003.

[B]How it works[/B]

Albumin is a substance that grabs toxic substances and transports them through the blood to the liver. In people with diseased or damaged liver, these toxins stay in the blood and cause damage.

In albumin dialysis, blood is pumped out of the body and filtered through a thin membrane containing albumin. The albumin on the membrane grabs the toxins from the blood and filters them out. The filtered blood is then pumped back into the body.

The University of Michigan researchers have already used the device on 20 desperately ill liver-failure patients in a preliminary clinical trial with promising results. Two patients recovered complete liver function.

Almost all of the remaining patients showed some improvement in liver function tests, and six patients lived long enough to receive a liver transplant. Results from the first nine patients were published in the August 2001 issue of Surgery.

The device is currently approved for use in Europe, but Bartlett says if the next trials go well, it will probably be about three years before the dialysis system is widely available in the USA.

"All of this is very exciting," Gordon says of Bartlett's research. "Livers can fail quite abruptly, and often people die on the waiting list. We don't have anything to offer them right now. If liver dialysis can tide people over till transplant -- even for days or weeks -- it could save lives." ?(HealthScout)