a simple dummy liver assist device prolongs anhepatic survival in a porcine model of total hepatectomy by slight hypothermia一个简单的虚拟肝脏辅助设备延长anhepatic生存在猪模型总肝切除术的轻微体温过低.pdfVIP

Thiel et al. BMC Gastroenterology 2011, 11:79 /1471-230X/11/79 RESEARCH ARTICLE Open Access A simple dummy liver assist device prolongs anhepatic survival in a porcine model of total hepatectomy by slight hypothermia 1 1 2 3 3 1 Karolin Thiel , Martin Schenk , Alexander Etspüler , Thomas Schenk , Matthias H Morgalla , Alfred Königsrainer and Christian Thiel1* Abstract Background: Advances in intensive care support such as therapeutic hypothermia or new liver assist devices have been the mainstay of treatment attempting to bridge the gap from acute liver failure to liver transplantation, but the efficacy of the available devices in reducing mortality has been questioned. To address this issue, the present animal study was aimed to analyze the pure clinical effects of a simple extracorporeal dummy device in an anhepatic porcine model of acute liver failure. Methods: Total hepatectomy was performed in ten female pigs followed by standardized intensive care support until death. Five animals (dummy group, n = 5) underwent additional cyclic connection to an extracorporeal dummy device which consisted of a plasma separation unit. The separated undetoxified plasma was completely returned to the pigs circulation without any plasma substitution or exchange in contrast to animals receiving intensive care support alone (control group, n = 5). All physiological parameters such as vital and ventilation parameters were monitored electronically; laboratory values and endotoxin levels were measured every 8 hours. Results: Survival of the dummy device group was 74 ± 6 hours in contrast to 53 ± 5 hours of the control group which was statistically significant (p 0.05). Body temperature 24 hours after hepatectomy