The researchers assessed the HepatAssist 2000, a liver-assist system containing porcine hepatocytes, as a bridge to transplantation in patients with acute liver failure.
Brain edema is the main cause of death in acute liver failure patients awaiting transplantation.
A total of 13 patients suffering from acute liver failure with criteria for transplantation entered an open baseline-controlled study. They were given liver-assist treatment sessions at 24-hour intervals until transplantation.
Neurological status was regularly evaluated using the Glasgow Coma Scale.
Of the patients, 3 were not treated: 1 had an immediate transplantation, and 2 improved spontaneously.
| HepatAssist 2000 courses significantly improved neurological status.
| Transplantation |
The other 10 patients received 1 to 3 courses of HepatAssist.
A significant neurological improvement (mean Glasgow Coma Scale before and after treatment: 6.5 and 9.6, respectively) was observed, which was related to the volume of plasma processed per square meter of body surface.
In addition, a significant decrease was observed in mean levels of bilirubin and transaminases, but not in the other indicators of liver function.
It was found that 6 patients had transient episodes of hemodynamic instability, and 5 had bleeding complications.
Two patients died after transplantation.
The remaining 8 patients survived with a mean follow-up of 24 months.
Professor Didier Samuel, of the Paul Brousse Hospital, Villejuif, concluded on behalf of the group, "The HepatAssist 2000 is well tolerated, improves cerebral function, and may be used as a bridge to transplantation for patients with liver failure."