Anest. intenziv. Med. 2010;21(4):207-212

Prometheus - a new therapeutic option in liver failure in childrenCase Report

Hladík Michal1,2,*, Zaoral Tomáš1, Čáp Jiří3
1 Klinika dětského lékařství Fakultní nemocnice Ostrava
2 Fakulta zdravotních studií, Ostravská univerzita, Ostrava
3 Klinika anesteziologie, resuscitace a intenzivní péče, Transplantcentrum, IKEM

Acute liver failure is a rare but potentially fatal condition with mortality reaching 80-90 %. Dialysis, haemoperfusion and countinuous renal replacement therapy are currently the methods of choice in patients with this critical condition.
Prometheus has been recently introduced in our PICU. This liver replacement device is designed to eliminate toxins produced during the liver failure state. So far two critically ill children - aged 7 years and 15 months - have been treated with Prometheus. Although unfortunately both the patients died of brain oedema, we witnessed a good elimination efficiency of the system. Ideal timing of the initiation of the therapy appears to be a crucial factor.

Keywords: acute liver failure; child; critical state; Prometheus; King'College Criteria

Published: August 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Hladík M, Zaoral T, Čáp J. Prometheus - a new therapeutic option in liver failure in children. Anest. intenziv. Med. 2010;21(4):207-212.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Thompson, A. E. Liver Failure in Infants and Children. p. 1027-1039. In: Wheeler, D. S., Wong, H. R., Shanley, T. P. (eds.) Pediatric Critical Care Medicine-Basic Science and Clinical Evidence. Springen.Verlag London, 2007, 1805 s.
    2. Rifai, K., Ernst, T., Kreschmer, U., Bahr, M. J., Schneider, A., Hafer, C., Haller, H., Manns, M. P., Fliser, D. Prometheus - a new extracorporeal systém for the treatment of liver failure. J. Hepatol., 2003, 39, 6, p. 984-990. Go to original source... Go to PubMed...
    3. Evenepoel, P., Laleman,W., Wilmer, A., Claes, K., Maes, B., Kuypers, D., Bammens, B., Nevens, F.,Vanrenterghem,Y. Detoxyfiing Capacity and Kinetics of Prometheus - A New Extracorporeal System for the Treatment of Liver Failure. Blood Purif, 2005, 23, p. 349-358. Go to original source... Go to PubMed...
    4. Falkenhagen, D., Strobl, W., Vogt, G., Schrefl, A., Linsberger, I., Gerner, F. J. Fractionated plasma separation and adsorption system: a novel system for blood purification to remove albumin bound substances. Artif. Organs, 1999, 23, p. 81-86. Go to original source... Go to PubMed...
    5. Kjaergard, L. L., Liu, J., Als-Nielsen, B., Gluud, C. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure. JAMA, 2003, 289, p. 217-222. Go to original source... Go to PubMed...
    6. Bailey, B., Amre, D., Gaudreault, P. Fulminant hepatic failure secondary to acetaminophen poisoning: a systematic review and meta-analysis of prognostic criteria determining the need for liver transplantation. Crit. Care Med., 2003, 31, 1, p. 299-305. Go to original source... Go to PubMed...
    7. Anand, A., Nightingale, P., Neuberger, J. Early indicators of prognosis in fulminant hepatic failure: an assessment of the King's criteria. J. Hepatol., 1997, 26, 1, p. 62-68. Go to original source... Go to PubMed...
    8. Shakil, A., Kramer, D., Mazariegos, G., Fung, J., Rakela, J. Acute liver failure: clinical features, outcome analysis, and applicability of prognostic criteria. Liver Transpl., 2000, 6, 2, p. 163-169. Go to original source... Go to PubMed...
    9. Enjalbert, F., Rapior, S. et al. Treatment of Amatoxin Poisoning - 20-Year Retrospective analysis. Journal of toxicology, 2002, 40, 6, p. 715-757. Go to original source... Go to PubMed...
    10. Broussard, C. N., Aggarwal, A., Lacey, S. R. et al. Mushroom poisoning - from diarrhea to liver transplantation. Am. J. Gastroenterol., 2001, 96, p. 3195-3198. Go to original source...
    11. Soysal, D., Çevik, C., Saklamaz, A., Yetimalar, Y., Ünsal, B. Coagulation disorders secondary to acute liver failure in Amanita phalloides poisoning. The Turkish Journal of Gastroenterology, 2006, 17, p. 198-200.
    12. Kramer, L., Bauer, E., Schenk, P. et al. Successful treatment of refractory cerebral oedema in ectasy/cocaine-induced fulminant hepatic failure using a new high-efficacy liver detoxification device (FPSA-Prometheus). Wien Klin. Wochenschr., 2003, 115, p. 559-603. Go to original source... Go to PubMed...
    13. Marcus, K. H., Kim, H. S., Beste, M. Removal of Metabolites, Cytokines and Hepatic Growth Factors by Extracorporeal Liver Support in Children. Journal of Pediatric Gastroenterology and Nutrition, 2005, 40, p. 54-55. Go to original source... Go to PubMed...
    14. Kieslichová, E., Ročeň, M., Trunečka, P., Janoušek, L., Šperl, J., Petrášek, J., Vítko, Š. Úspěšná léčba akutního renálního selhání jater pomocí přístrojové podpůrné terapie s následnou transplantací jater. Prakt. Lék., 2006, 86, 5, p. 275-277.
    15. Lee, W. Liver Failure and Liver Support. Seminars in Liver Disease. 2008, 28, 2, p. 135-136. Go to original source... Go to PubMed...

    Return to the content


    Anesteziologie a intenzivní medicína

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.