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The elusive goal of liver support – quest for the Holy Grail

Roger Williams
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DOI: https://doi.org/10.7861/clinmedicine.6-5-482
Clin Med September 2006
Roger Williams
UCL Institute of Hepatology, Division of Medicine, University College London
Roles: Director
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Abstract

The history of liver support devices is traced from early attempts with dialysis based on the known dialysability of ammonia – the major identified toxin in liver failure – and exchange transfusion with removal of protein-bound toxins, to the later techniques based on whole organ perfusion in extracorporeal circuits. Perfusion through charcoal as an adsorbent represented a major advance and remains a component of more recently introduced devices based on bioreactors of cultured hepatocytes and in the albumin dialysis techniques of molecular adsorbent recirculating system and the Prometheus device. The latter are the most highly efficient to date in toxin removal but whether survival is improved and the need for liver transplantation remain to be proven.

Key Words
  • albumin dialysis
  • bioartificial devices
  • charcoal haemoperfusion
  • liver failure
  • water-soluble/protein-bound toxins
  • © 2006 Royal College of Physicians
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The elusive goal of liver support – quest for the Holy Grail
Roger Williams
Clinical Medicine Sep 2006, 6 (5) 482-487; DOI: 10.7861/clinmedicine.6-5-482

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The elusive goal of liver support – quest for the Holy Grail
Roger Williams
Clinical Medicine Sep 2006, 6 (5) 482-487; DOI: 10.7861/clinmedicine.6-5-482
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