ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
with AoCLF; no improvement was
witnessed in the 2 patients with ALF.
HESA and GCS scores remained stable
or improved in all 5 patients.
Conclusion: Despite the high mortality
rate, patients with AKI and liver failure
benefit <strong>from</strong> treatment with MARS and
CVVHDF which increases the time until
a liver transplant can be performed.
Indication
for MARS
Days on
MARS
Outcome
Change in
HESA
Change in
GCS
Change
in total
bilirubin
Change in
creatinine
Pt 1 Pt 2 Pt 3 Pt 4 Pt 5
Hep B
cirrhosis
Hep C
cirrhosis
Acetami
nophen
induced
acute
liver
failure
Nonalc
oholic
steato
hepatiti
s
cirrhosi
s
4 5 1 2 1
Discharg
ed on
Dialysis
Liver
Transpla
nt
Liver
Transpl
ant
Death
Liver
lympho
ma
Death
1 (3->2) 1 (3->2) N/A N/A N/A
7 to 15 15 to 15 5 to 5 3 to 3 7 to 7
↓49.2%
↓17.2%
↑165.6
%
↓58.3% ↓76.2% ↓34.2% ↓66%
↓12.8% ↑6.4%
↓32.1
%
90. Impact of Albumin Dialysis on
Albumin Binding Function
Jan Stange, Maria Kretschmann, Sarah
Froehlich, Birka Krellenberg, Melanie
Stiffel, Sebastian Koball, Joerg
Henschel, Martin Gloger, Martin
Eggert, Steffen Mitzner
Center for Organ Support &
Regeneration, Dept. Medicine, Intensive
Care Unit
Background: Liver Failure is associated
with an accumulation of endogenous
toxins at the main albumin binding site
for multiple vasoactive, neuro-, nephroand
hepatotoxic metabolites (Klammt et
al. EJGH 27). The resulting binding
dysfunction can be quantified using
fluorescence markers competing for
binding sites with said toxins The
Albumin Binding Capacity (ABiC)
correlates with mortality. Patients in who
ABiC can be improved within 7 days
have a mortality of only 6.25% while
patients who maintain a low binding
capacity below 4% over 7 days despite
treatment have a mortality of 83%
(Klammt et. al. Liver Transplantation
28). Therapeutic means to improve
ABiC include extracorporeal
detoxification removing albumin bound
toxins and infusion of albumin. The
effect of the latter is limited by the
occupation of therapeutic albumin
binding sites by commercial
conservatives such as Caprylate and N-
Acetyltryptophane (Stange et al. Liver
Transplantation 211). Since Albumin
Dialysis so far is based on commercial
albumin as Dialysate the effect of
stabilizers on capability to improve
ABiC was investigated. Methods:
Plasma samples were taken before and
after Mars treatments in patients
suffering <strong>from</strong> liver failure. Bilirubin,
Bile Acids and ABiC was measured
before and after treatments and
193