Temporary extracorporeal liver support for severe acute alcoholic hepatitis using the BioLogic-DT

Patients with severe acute alcoholic hepatitis develop multiple organ failu re which is associated with production of inflammatory cytokines and a poor prognosis. The aim of the present pilot study was to evaluate the effects of the BioLogic-DT sorption-suspension, dialyser in patients with severe ac ute alcoholic hepatitis. Ten patients with encephalopathy (grade II-IV) wer e entered into the study, 5 received treatment with the BioLogic-DT for 6 h ours daily for 3 days and 5 received conventional treatment as controls. Th e system was biocompatible with no adverse effects on blood pressure or pla telet counts, factor V, fibrinogen or antithrombin ill. No bleeding episode s were observed even with the use of small doses of heparin. After 3 days, blood ammonia was lower in the BioLogic-DT treated patients than in the con trols, although blood lactate was higher. There were slight increases in pl asma TNF and IL-8 during treatment over and above the higher levels present initially, possibly as a result of activation of white cells in the extrac orporeal circuit. The further development of the BioLogic-DT dialyser with the addition of a plasma treatment module capable of removing cytokines wou ld be worth evaluating in acute alcoholic hepatitis.