Improvement of impaired albumin binding capacity in acute‐on‐chronic liver failure by albumin dialysis

Extracorporeal albumin dialysis (ECAD) enables the elimination of albumin bound substances and is used as artificial liver support system. Albumin binding function for the benzodiazepine binding site specific marker Dansylsarcosine was estimated in plasma samples of 22 patients with cirrhosis and hy...

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Bibliographic Details
Published in:Liver transplantation 2008-09, Vol.14 (9), p.1333-1339
Main Authors: Klammt, Sebastian, Mitzner, Steffen R., Stange, Jan, Loock, Jan, Heemann, Uwe, Emmrich, Jörg, Reisinger, Emil C., Schmidt, Reinhard
Format: Article
Language:English
Subjects:
Adult
Albumins - chemistry
Albumins - metabolism
Benzodiazepines - chemistry
Bile Acids and Salts - chemistry
Bilirubin - chemistry
Binding Sites
Dansyl Compounds - chemistry
Dialysis - methods
Female
Fibrosis - metabolism
Humans
Liver Failure - therapy
Male
Middle Aged
Sarcosine - analogs & derivatives
Sarcosine - chemistry
Treatment Outcome
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Summary:Extracorporeal albumin dialysis (ECAD) enables the elimination of albumin bound substances and is used as artificial liver support system. Albumin binding function for the benzodiazepine binding site specific marker Dansylsarcosine was estimated in plasma samples of 22 patients with cirrhosis and hyperbilirubinaemia (ECAD: n = 12; control: n = 10) during a period of 30 days in a randomized controlled clinical ECAD trial. Albumin Binding Capacity (ABiC) at baseline was reduced to 31.8% (median; range 24%‐74%) and correlated to the severity of liver disease. Within two weeks a significant improvement of ABiC and a reduction of the albumin bound markers bilirubin and bile acids were observed in the ECAD group. During single treatments a significant decrease of albumin bound substances (bilirubin and bile acids) as well as an increase in ABiC was observed. In the control group, baseline ABiC was significantly lower in patients who died during study period (34.2% vs. 41.7%; P < 0.028), whereas no significant differences were observed for CHILD, coagulation factors, albumin, bile acids nor bilirubin. At baseline 13 patients had a severely impaired ABiC (
ISSN:1527-6465
1527-6473
DOI:10.1002/lt.21504