Prométheus - an Effective Supportive Therapy of Acute Liver Failure. Experimental Study on a Large Laboratory Animal
Abstract
Introduction: Lately eliminative methods have developed which enable an effective treatment of patients with acute liver failure (ALF) waiting for liver transplantation or spontaneous liver parenchyma regeneration. Aim of the study: To evaluate the effectiveness of non-biological method FPSA (Fractionated plasma separation and adsorption) in the treatment of experimental ALF on a big laboratory animal.
Methods: Surgical model of ALF with liver devascularization in pigs weighting 25-40 kg was provided following monitoring of ALF markers (AST, ALT, bilirubin, ammonia, glycaemia, INR) including intracranial pressure (ICP). A control group without treatment of ALF was performed. 14 pigs weighting 35 kg (35 +- 5 kg) with the identical ALF were treated by Prométheus (FPSA).
Results were compared with the control group and statistically worked on by the T-test and Mann-Whitney non-parametric test using tabulator EXCEL and QUATRO. Results: The level of bilirubin serum in the experimental group comparing with the control group was significantly lower (p < 0.05) within 6th hour 12.81 +- 6.54 vs. 29.84 +- 9.99 within 9th hour 11.94 +- 4.14 vs. 29.95 +- 12.36 and within 12th hour 13.88 +- 6.31 vs. 26.10 +- 12.23 mmol/l.
The significant difference in ammonia serum level was not founded. ICP was significantly different from 9th hour to 12th hour in favour of FPSA group (p < 0.05): 9th hour 19.1 +- 4.09 vs. 24.1 +- 2.85, 10th hour 21.9 +- 3.63 vs. 25.1 +- 2.19, 11th hour 22.5 +- 3.98 vs. 26.3 +- 3.50 and 12th hour 24.0 +- 4.66 vs. 29.8 +- 5.88 mm Hg.
Conclusion: Using the FPSA method (Prométheus) the significant decrease of bilirubin and ICP was proved by the authors on a surgical devascularization model of acute liver failure in the experiment on a big laboratory animal. The method is suitable for a supportive therapy of the acute liver failure in ROLE 3.