Abstract
The present narrative review on albumin dialysis provides evidence-based and expert opinion guidelines for clinicians caring for adult patients with different types of liver failure. The review was prepared by an expert panel of 13 members with liver and ntensive care expertise in extracorporeal liver support therapies for the management of patients with liver failure. The coordinating committee developed the questions according to their importance in the management of patients with liver failure. For each indication, experts conducted a comprehensive review of the literature aiming to identify the best available evidence and assessed the quality of evidence based on the literature and their experience. Summary statements and expert’s recommendations covered all indications of albumin dialysis therapy in patients with liver failure, timing and intensity of treatment, efficacy, technical issues related to the device and safety. The panel supports the data from the literature that albumin dialysis showed a beneficial effect on hepatic encephalopathy, refractory pruritus, renal function, reduction of cholestasis and jaundice. However, the trials lacked to show a clear beneficial effect on overall survival. A short-term survival benefit at 15 and 21 days respectively in acute and acute-on-chronic liver failure has been reported in recent studies. The technique should be limited to patients with a transplant project, to centers experienced in the management of advanced liver disease. The use of extracorporeal albumin dialysis could be beneficial in selected patients with advanced liver diseases listed for transplant or with a transplant project. Waiting future large randomized controlled trials, this panel experts’ statements may help careful patient selection and better treatment modalities.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Intensive Care Medicine |
| Vol/bind | 48 |
| Udgave nummer | 10 |
| Sider (fra-til) | 1352-1367 |
| Antal sider | 16 |
| ISSN | 0342-4642 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:FS has received speaker’s honoraria and/or research grants from Novartis, Astellas, Chiesi, Gilead, Merck Sharp and Dohme, Neovie, Biotest and Baxter. RB has received speaker’s honoraria and/or research grants from Gilead, abbvie, Janssen, Gore Baxter. FL has nothing to declare. AW has no conflict of interest. AP has received grant funding, personal fees, and advisory board fees from Intercept Pharmaceuticals and Genfit; advisory board fees and fees for teaching from Novartis; and personal fees from CymaBay Therapeutics and Inova Diagnostics. SM has received speaker`s honoraria and/or research grants from Amgen, Astellas, Baxter, BMS/Pfizer, CytoSorbents, Pentracor, Vifor. JS is chairman of the board of Albutec GmbH. VF declare presentations for Fresenius, Baxter, ADVITOS, CSL-Behring, Merz, Advisory board. SG declare no conflict of interest. TH is consultant for DIALIVE. On advisory committee and received consultancy from AbbVie, Bristol-Myers Squibb, Gilead, Malinckrodt, Merck, and Organovo. Received research grants from AbbVie, Allergan, Amarex/Cytodyn, Astra Zeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, CARA, DURECT Corporation, Enanta, Galectin, Gilead, Grifols, Intercept, Merck, Mirum, Novartis, Novo Nordisk, Pfizer, Salix Pharmaceuticals, Sonic Incytes, and Terns Pharmaceuticals. DS received research grants Astellas and honoraria from Goliver and Biotest. JT, declare no conflict of interest. JT declares no conflict of interest. SJ declares consulting fees from Drager, Fresenius-Xenios, Medtronic, Mindray and Fisher & Paykel.
Publisher Copyright:
© 2022, Springer-Verlag GmbH Germany, part of Springer Nature.