Abstract

The Effect of Extracorporeal Albumin Dialysis (ECAD) on Pruritus Using MARS Versus New Adsorbent Recirculation (OPAL)

Highlights

  • Extracorporeal albumin dialysis (ECAD) is a therapy where the dialysis solution is enriched with human albumin in order to enhance the removal of albumin bound toxins (ABT), which are thought to play a key role in cholestatic pruritus and other liver decompensations [1]

  • Four experienced liver centers could show in a prospective randomized cross-over study (EUDAMED: CIV-13-04010642) that implementing a new adsorbent (HepalbinTMCluster12) for dialysate albumin regeneration in the OPALTM system resulted into a new quality of Extracorporeal Albumin Dialysis (ECAD) by removing ABTs more effectively, but the higher detoxification dose delivered led to an improvement of patient’s endogenous albumin binding function [3] measured by Electron Spin Resonance Spectroscopy (ESR)

  • MARSTM has been shown in the past to remove ABTs it had failed in a past study to improve ESR, which is considered a potential surrogate for survival [4]

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Summary

Introduction

Extracorporeal albumin dialysis (ECAD) is a therapy where the dialysis solution is enriched with human albumin in order to enhance the removal of albumin bound toxins (ABT), which are thought to play a key role in cholestatic pruritus and other liver decompensations [1]. In order to maintain an effective concentration gradient for ABT, effective ECAD requires the use of highly purified albumin in the dialysate. Four experienced liver centers could show in a prospective randomized cross-over study (EUDAMED: CIV-13-04010642) that implementing a new adsorbent (HepalbinTMCluster12) for dialysate albumin regeneration in the OPALTM system resulted into a new quality of ECAD by removing ABTs more effectively, but the higher detoxification dose delivered led to an improvement of patient’s endogenous albumin binding function [3] measured by Electron Spin Resonance Spectroscopy (ESR). How the performance of the new adsorbent affects effectiveness of pruritus treatment has not been shown in a larger cohort yet

Aim
Patients and Methods
Results
Discussion

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