Liver Assist by Push-Pull Sorbent-Regenerative Pheresis

Acute hepatic failure (AHF) with Stage 4 coma is a serious illness with over 60% mortality when tresupportive therapy. The BioLogic-DT is an extracorporeal liver support device which uses the membranplate dialyzer to propel blood through a single access and circulates a suspension of powdered charcexchanger sorbents through the dialysate spaces. This device effectively removes dialyzable organicbut is mostly ineffective in removing protein-bound toxins. Nonetheless, over 80% of liver failure pphysiologically and neurologically during treatment with the device; most recover liver function ofttransplant. In the current study, we will place an albumin-permeable hollow-fiber plasmafilter downsdialyzer, and use the alternating pressure of the blood to drive plasma filtrate (with albumin) into(where interaction with charcoal will remove toxins), then return the albumin to the blood. In vitroclearance rate of the system for albumin-bound substances such as bromsulphthalein (BSP), bilirubin,drugs, and the clearance for non-albumin-bound substances such as creatinine and ammonium. If warranclinical studies will determine whether the new chemical functions of the sorbent improve the treatmhepatic coma.