J.Jpn. Surg. Soc.. 86(9): 1027-1030, 1985

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Report on the annual meeting

ARTIFICAL LIVER

An artificial liver should in fact be called an artificial liver assist device or system because at this point in its development it is unable to prolong the life of an ahepatic animal, whereas, an artificial heart or an artificial kidney enables the animal to live without a heart or kidneys for a long period of time.
The hepatic assist devices are classified into three types : Artificial (charcoal hemoperfusion, PAN membrane dialysis or filtration) ; biological (baboon liver perfusion, cross dialysis between pig liver and patients systemic circulation) ; and hybrid (combined form of artificial and biological).
Our hepatic support system is composed of a membrane plasma separator, blood and plasma pumps, hemodialyzer and controller. Using this system, the patients plasma is replaced with fresh donor plasma in amount of 5,000ml daily. This procedure are taken place in the intensive care unit, until the patient recovers consciousness or his cerebral death is comfirmed.
A national survey of the patients with fulminant hepatic failure, revealed that the survival rate of the patients treated with plasma exchange was 34.1％ (15/45), while that of the patient untreated with plasma exchange was 14.3％ (5/35). The difference is statistically significant.
However, plasma exchange requires a large amount of fresh plasma which occasionally induce hepatitis or allergy and its detoxication of the patients plasma was insufficient in severe cases. To overcome these problems, specific adsorpton of hepatic toxins and a combined therapy of blood purification with plasma exchange will be studied further.

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