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Detoxification of bilirubin and bile acids with intermittent coupled plasmafiltration and adsorption in liver failure (HERCOLE study) by Gabriele Donati; Andrea Angeletti; Lorenzo Gasperoni; Fabio Piscaglia; Anna Laura Croci Chiocchini; Anna Scrivo; Teresa Natali; Ines Ullo; Chiara Guglielmo; Patrizia Simoni; Rita Mancini; Luigi Bolondi; Gaetano La Manna is a Medicine article available to read on EtoBox.

What is Detoxification of bilirubin and bile acids with intermittent coupled plasmafiltration and adsorption in liver failure (HERCOLE study) about?

## Abstract ## Background CPFA is an extracorporeal treatment used in severe sepsis to remove circulating proinflammatory cytokines. Limited evidence exists on the effectiveness of bilirubin adsorption by the hydrophobic styrenic resin, the distinctive part of CPFA. The aim of this study is to validate CPFA effectiveness in liver detoxification. ## Methods In this prospective observational study, we enrolled patients with acute or acute-on-chronic liver failure (serum total bilirubin > 20 mg/dL or MELD Score > 20) hospitalized from June 2013 to November 2017. CPFA was performed using the Lynda (Bellco/MedTronic, Mirandola, Italy) or the Amplya (Bellco/MedTronic, Mirandola, Italy) machines. Anticoagulation was provided with unfractionated heparin or citrate. Bilirubin and bile acids reduction ratios per session (RRs) were the main parameters for hepatic detoxification. ## Results Twelve patients with acute (n = 3) or acute-on-chronic (n = 9) liver failure were enrolled. Alcohol was the main cause of liver disease. Thirty-one CPFA treatments of 6 h each were performed, 19 with heparin and 12 with citrate. RRs was 28.8% (range 2.2–40.5) for total bilirubin, 32.7% (range 8.3–48.9) for

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Author

Gabriele Donati; Andrea Angeletti; Lorenzo Gasperoni; Fabio Piscaglia; Anna Laura Croci Chiocchini; Anna Scrivo; Teresa Natali; Ines Ullo; Chiara Guglielmo; Patrizia Simoni; Rita Mancini; Luigi Bolondi; Gaetano La Manna

Publisher

Springer Science and Business Media LLC

Published

2020

Language

EN

Field

Medicine (Health Sciences)