Experimental Study On Plasm Exchange And Hemofiltration For Pigs With Acute Hepatic Failure

Objective To evaluate the efficacy and approach the mechanism of combined nonbioartificial liver (plasm exchange plus hemofiltration) for large animal model of acute hepatic failure induced by D-galactosamine.Methods 11 pigs were divided into two groups at random: control group (n=5) and treatment group (n=6). All of the animals were induced acute hepatic failure with administration of D-galactosamine firstly. 24h and 48h later the animals in the treatment group were treated with plasm exchange (PE) combined with hemofiltration (HF) respectively. No intervention in the control group. Efficacy was assessed by dynamic comparing general condition, biochemical, PTA, cytokine(TNF-a,IL-1β,IL-6) and pathological changes, also with the live time and survival.Results After treatment animals' condition were improved. There are significant differences for serum aminotransferase, bilirubin, PTA, TNF-a,IL-1β,IL-6, pathological manifestation between two groups at the same time and between the prior-and post-treatment in the treatment group. Degree of liver injury correlated with the level of serum cytokine. The treatment group's mean live time was (101.50±13.31) h, which was much longer than that in the control group ( 61.20±11.63 ) h (p<0.01), and the survival has statistical significance (p<0.01).Conclusions Through fractional clearance mediators of inflammation, two times of combined nonbioartificial liver (PE plus HF ) is effective for acute hepatic failure, and may be a good aid measure for clinical treatment.