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Long‐Term Survivors with Artificial Liver Support in Fulminant Hepatic Failure
Authors:Masakazu Nitta  Hiroyuki Hirasawa  Shigeto Oda  Hidetoshi Shiga  Kazuya Nakanishi  Kenichi Matsuda  Masataka Nakamura  Kennji Yokohari  Takeshi Hirano  Yoh Hirayama  Takeshi Moriguchi  Eizou Watanabe
Abstract:Abstract: Clinical ability of artificial liver support (ALS) has been improved greatly in recent years which has allowed us to encounter long‐term survivors with fulminant hepatic failure (FHF) whose liver function has been almost completely lost. This suggests that application of ALS in patients with FHF gains time while awaiting transplantation as well as time for functional recovery and regeneration of the liver graft following receipt of the graft with marginal function and/or size. Thus, ALS will contribute greatly to extending the indications for liver transplantation and increase the number of patients receiving and benefiting from this treatment. On the other hand, introduction of ALS prolongs the duration of intensive treatment which increases the risk of infection and increases medical costs. In addition, when to discontinue intensive treatment of patients whose level of consciousness is maintained only by ALS is controversial. Thus, further investigation will be needed to establish a consensus on indications for long‐term ALS in FHF.
Keywords:Long‐term survivors  Fulminant hepatic failure  Artificial liver support  High‐flow dialysate continuous hemodiafiltration  Slow plasma exchange  Intracranial pressure
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