Anest. intenziv. Med. 2010;21(4):199-205

Prometheus therapy in patients with acute liver failure - the effect on the inflammation and regeneration markersOriginal Article

Ročeň Milan1,*, Kieslichová Eva1, Merta Dušan1, Pavlova Jelena2, Čáp Jiří1, Trunečka Pavel3
1 Klinika anesteziologie, resuscitace a intenzivní péče, Transplantcentrum IKEM, Praha
2 Oddělení imunogenetiky, Pracoviště laboratorních metod IKEM, Praha
3 Transplantcentrum IKEM, Praha

Objective:
Prometheus, a device based on modified fractionated plasma separation and adsorption, is used in the therapy of acute liver failure as a bridging to liver transplantation. The therapeutic effect of Prometheus is not limited just to the elimination of terminal metabolites, therefore the aim of the study was to identify the effect of this method on the levels of cytokines and inflammation and liver regeneration markers. The effect on encephalopathy, haemodynamics and time on the waiting list for liver transplantation was also observed.

Materials and methods:
Total 11 patients with acute liver failure were investigated. These patients underwent 37 therapeutic sessions on Prometheus . Before and after each treatment session the serum concentrations of selected cytokines and inflammation and liver regeneration markers were measured, and the kinetics of their serum concentrations were evaluated.

Results:
Before the therapy, elevated levels of some cytokines and inflammation markers were detected. Some of them decreased significantly during the therapy. By contrast, the level of the Hepatocyte Growth Factor was increased. The treatment did improve encephalopathy and time on the waiting list but no effect on the hemodynamics was found.

Conclusion:
Our results show that Prometheus is effective in the clearance of some of the inflammatory mediators and affects the serum levels of the inflammatory and regeneration markers that are important in the therapeutic approach to acute liver failure management.

Keywords: acute liver failure; cytokines; encephalopathy; inflammatory markers; Prometheus; regeneration

Published: August 1, 2010  Show citation

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Ročeň M, Kieslichová E, Merta D, Pavlova J, Čáp J, Trunečka P. Prometheus therapy in patients with acute liver failure - the effect on the inflammation and regeneration markers. Anest. intenziv. Med. 2010;21(4):199-205.
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