著者
中永,士師明
出版者
日本アフェレシス学会
雑誌
日本アフェレシス学会雑誌
巻号頁・発行日
vol.22, no.3, 2003-10-31

Plasma exchange (PE) is a well-established blood purification therapy for treating fulminant hepatic failure. However, we previously reported that cytokines are not removed by PE alone, and combining PE and continuous hemodiafiltration (CHDF) is an effective modality for suppressing the elevation of blood citrate levels and for removing inflammatory cytokines. We devised a series-parallel method to raise the removal efficiency. In the series-parallel method, total bilirubin was significantly removed after treatment in comparison with the reverse-parallel method. Interleukin-18, which plays an important role in the pathophysiology of hepatic failure, was also significantly removed by the series-parallel method. The series-parallel method, which combines both advantages of the parallel and series methods, is a valuable therapy for the treatment of fulminant hepatic failure.