A Case-Control Study of Single-Pass Albumin Dialysis for Acetaminophen-Induced Acute Liver Failure

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Abstract
Background: Extracorporeal support with single-pass albumin dialysis (SPAD) may remove protein-bound toxins in acute liver failure. We evaluated the clinical, physiological and laboratory parameters of SPAD in acetaminophen-induced acute liver failure (AALF). Methods: Retrospective case-control studies of AALF patients were used. Results: We identified 13 AALF patients ( 6 SPAD-treated, 7 controls). The average age was 38 years, 92% were female, none had cirrhosis and the Model for End-Stage Liver Disease (MELD) scores were 43. Eleven patients (85%) fulfilled the King's College criteria for a liver transplant. SPAD-treated patients received 21 sessions ( total: 147 h, mean 3.5 runs or 24.5 h/patient). There were no complications. No significant changes in clinical, physiological or biochemical parameters occurred during SPAD. Compared with the controls, there were no significant differences in ICU or 1-year survival, liver recovery or referral for a liver transplant. Conclusion: SPAD was well-tolerated in AALF; however, it was not associated with differences in clinical outcomes. While SPAD may be an adjuvant supportive therapy in AALF, prospective trials are needed. Copyright (C) 2009 S. Karger AG, Basel