ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> Category 1c. LIVER TRANSPLANTATION / SURGERY: c. ACUTE LIVER FAILURE - CLINICAL & EXPERIMENTAL<br><b>Presentation Date:</b> Apr 17, 2010</P><h2 align='left'><B>IMPROVEMENT OF SURVIVAL IN A SWINE MODEL OF ACUTE LIVER FAILURE BY A NEW LIVER SUPPORT SYSTEM (HEPA WASH®) </B></h2> <p align='left'><b>A. Al-Chalabi</b><sup>1</sup>*, E. Matevossian<sup>2</sup>, A.-K. Preissel<sup>3</sup>, Z. Yang<sup>1</sup>, C. Schreiber<sup>1</sup>, P. Schimmel<sup>1</sup>, E. Nairz<sup>1</sup>, H. Yan<sup>1</sup>, A. Geiger<sup>1</sup>, B. Kreymann<sup>4</sup><br> <em><sup>1</sup>II Medizinische Klinik, <sup>2</sup>Chirurgische Klinik und Poliklinik, <sup>3</sup>Zentrum für Präklinische Forschung, Klinikum rechts der Isar, <sup>4</sup>Hepa Wash GmbH, Munich, Germany. *ahmed.al-chalabi@lrz.tum.de</em></p><br> <p align='justify'><b><b>Background and aims: </b></b> Hepa Wash® is a new liver support system that employs albumin dialysis and a recycling procedure. An established model of acute liver failure (ALF) in pigs was used to assess safety and effectivity of the system. <br><b><b>Methods: </b></b> German landrace pigs (60.4 ± 1.8 kg; mean ± SEM) were randomly allocated to the control (n=5) and Hepa Wash (n=6) groups. Several validated procedures were followed for induction, monitoring and treatment of ALF. Animals underwent functional end-to-side portosystemic shunt and ligation of hepatic arteries. Intracranial pressure was measured and a goal-directed fluid therapy using the PiCCOplus system was done. The severity of ALF was evaluated with the LiMON® system. Treatment with Hepa Wash was started when the cerebral perfusion pressure (CPP) reached 45 mmHg and continued for 8 hours. <br><b><b>Results: </b></b> All animals in the Hepa Wash group survived the 13-hour observation period, except for one that died after stopping treatment. Four of the control animals died within this period (p=.03). Hepa Wash has significantly improved the values of CPP (23 ± 2 vs. 10 ± 3 mmHg, p=.006) and mean arterial pressure (37 ± 1 vs. 24 ± 2 mmHg, p=.006). Hepa Wash also enhanced heart index (4.94 ± 0.32 vs. 3.36 ± 0.25 l/min/m<sup>2</sup>, p=.006) (figure) and renal function (urine production, 1849 ± 565 vs. 417 ± 178 ml, p=.045) and eliminated water soluble (creatinine, 1.3 ± 0.2 vs. 3.2 ± 0.3 mg/dl, p=.01; ammonia 562 ± 124 vs. 1382 ± 92 µg/dl, p=.006) and protein-bound toxins (nitrate/nitrite 5.54 ± 1.57 vs. 49.82 ± 13.27 µmol/l, p= .02). Hepa Wash did not result in any adverse events during treatment. <br><b><b>Conclusions: </b></b> The Hepa Wash is a safe procedure and improves survival in a pig model of ALF. We conclude that the survival benefit was the result of amelioration of different organ functions in association with the excellent detoxification capacity of water soluble and protein-bound toxins. <br><b>Acknowledgments:</b> Authors are thankful for Support of Bayerische Forschungsstiftung. <br><b><br><img hspace=5 vspace=5 src=pictures/p_248_00005.jpg ><br><i>[Hepa Wash stabilized heart index in ALF]</i><br></b><br><br></p> <img src='pictures/p_248_00005.jpg'> <br><a href='Session-P03-1c.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>