Abstract
The present study was undertaken to investigate the efficacy of charcoal hemoadsorption (HA) in the treatment of acute hepatic failure (AHF). The effect of HA on the survival of AHF rats and the reticuloendothelial system (RES) function were studied experimentally. The survival of HA treatment group was significantly improved compared to the control. The EC, AKBR and RES function were significantly improved among HA treatment group compared to those among the control. In clinical study, since 1975 to 1983, 28 AHF patients were hemoadsorbed. The study period was divided into three terms according to the treatments. During the third term, HA and plasma exchange were performed alternatively in the AHF patients even though they were in grade II coma. The survival among patients treated during the third term was significantly improved compared to those treated during the first and second term. The hepatic cellular energy metabolism, studied using AKBR, was improved following HA. These data indicate that HA has the beneficial effect on the survival of AHF and that the mechanism of the beneficial effect could be through the improvement of hepatic energy metabolism. The data also indicate that HA is more effective when it is applied to the patients who are still in early stage of AHF.
