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Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure
140
Abstracts
Kan-I (bile acid Cokamino acid N-acyltransferase) messenger RNA as a novel predictive indicator for prognosis of bepatocelhdar carcinoma patients after partial hepatectomy Furutani M.; Arii 8; Higashitsuji H.; Mise M.; Niwano M.; Harada T.; Nakayama H.; Fukumoto M.; Imamura M.; Fujita J. Department 01‘ Clinical Molecular Biology, Faculty of’ Medicine, Kyoto University, 54 Shogoin-kawuharacho, Sakyo-ku, Kyoto 606-01 HEPATOLOGY 1996 24/6 (l441- 1445) We identified kan-I complementary DNA (cDNA), the sequence of which is identical to bile acid CoA:amino acid N-acyltransferase (BAT), a liver enzyme that catalyzes the conjugation of bile acids with glycine or taurine. Kan-l(BAT) messenger RNA (mRNA) levels of the resected specimens obtained from 37 hepatocellular carcinoma (HCC) patients were studied in an attempt to evaluate prognostic significance in HCC patients after partial hepatectomy. Using Northern blot hybridization, kan-l(BAT) mRNA levels were quantified in tumorous and nontumorous tissues, and the ratio of the former to the latter was defined as the kan-l(BAT) ratio. Patients, 12, had a kan-l(BAT) ratio less than 0.5 (low kan-l[BAT] ratio), and 25 patients had a ratio greater than 0.5 (high kan-l[BAT] ratio). The patients with a low kan-l(BAT) ratio demonstrated poorer survival than the patients with a high kan-l(BAT) ratio (P= 0.0013). The overall estimated hazard ratio for death in patients with a low kan-l(BAT) ratio was 68.05 according to a multivariate model (P = 0.0005). Thus, the kan-l(BAT) ratio may serve as a new molecular prognostic marker in HCC patients, following hepatic resection. 96363980 Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure Ellis A.J.; Hughes R.D.:Wendon J.A.;Dunne J.;Langley P.G.; Kelly J.H.; Gislason G.T.; Sussman N.L.; Williams R. Institute of’ Liver Studies, King’s Coil. School of Medicine/Dentistry, Bessemer Rd., London SE5 9PJ HEPATOLOGY 1996 2416 (144661451) The objective of this pilot controlled study was to evaluate the extracorporeal liver assist device (ELAD) in patients with acute liver failure who were judged to still have a significant chance of survival ( - 50%) and in those who had already fulfilled criteria for transplantation. Patients. 24, were divided into two groups, 17 with a potentially recoverable lesion (group I) and 7 listed for transplantation (group II), and then randomly allocated to ELAD haemoperfusion or control. The median period of ELAD haemoperfusion was 72 h (range 3- 168 h). Biocompatibility of the device was good, with no acceleration in platelet consumption, and haemodynamic stability was maintained. Two patients were withdrawn from the study because of worsening of preexisting disseminated intravascular coagulation in one case and a hypersensitivity reaction in the other. Deterioration with respect to encephalopathy grade was more frequent in the control patients, 7 of 12 (58%) than in the ELAD-treated patients, 3 of 12 (25%). In group I where survival for the ELAD cases was 7 of 9 (78%) there was a higher than expected survival in the controls, 6 of 8 (75%). For group II cases, survival was 1 of 3 (33”/1) for the ELAD-treated patients, and 1 of 4 (25%) for the controls. Both of the survivors underwent transplantation. Assessment of additive function for the device revealed an improvement in galactose elimination capacity after 6 h of haemoperfusion. Based on the results of this pilot-controlled trial, better indices of prognosis will be required, in addition to those used to select for transplantation, if patients at an earlier stage of clinical deterioration are to be included in future studies. 9636398 1 What constitutes long term survival after surgery for hilar cholangiocarcinoma? Klempnauer J.; Ridder G.J.; Werner M.; Weimann A.; Pichlmayr R. KA T, Medizinishe Hochschule Hannover, D -30 623 Hunnover CANCER 1997 79/l (26-34) Background: Hilar cholangiocarcinomas are rarely considered to be respectable and specific data regarding long term survival are not available. Methods: A retrospective single center experience from 1971 and 1995 details long term survival among 339 patients who underwent surgery for adenocarcinema of the hepatic duct bifurcation. Tumor removal was accomplished by resection of the bile duct bifurcation either alone (33 patients), in combination with hepatic resection (77 patients), or combined
Abstracts
Kan-I (bile acid Cokamino acid N-acyltransferase) messenger RNA as a novel predictive indicator for prognosis of bepatocelhdar carcinoma patients after partial hepatectomy Furutani M.; Arii 8; Higashitsuji H.; Mise M.; Niwano M.; Harada T.; Nakayama H.; Fukumoto M.; Imamura M.; Fujita J. Department 01‘ Clinical Molecular Biology, Faculty of’ Medicine, Kyoto University, 54 Shogoin-kawuharacho, Sakyo-ku, Kyoto 606-01 HEPATOLOGY 1996 24/6 (l441- 1445) We identified kan-I complementary DNA (cDNA), the sequence of which is identical to bile acid CoA:amino acid N-acyltransferase (BAT), a liver enzyme that catalyzes the conjugation of bile acids with glycine or taurine. Kan-l(BAT) messenger RNA (mRNA) levels of the resected specimens obtained from 37 hepatocellular carcinoma (HCC) patients were studied in an attempt to evaluate prognostic significance in HCC patients after partial hepatectomy. Using Northern blot hybridization, kan-l(BAT) mRNA levels were quantified in tumorous and nontumorous tissues, and the ratio of the former to the latter was defined as the kan-l(BAT) ratio. Patients, 12, had a kan-l(BAT) ratio less than 0.5 (low kan-l[BAT] ratio), and 25 patients had a ratio greater than 0.5 (high kan-l[BAT] ratio). The patients with a low kan-l(BAT) ratio demonstrated poorer survival than the patients with a high kan-l(BAT) ratio (P= 0.0013). The overall estimated hazard ratio for death in patients with a low kan-l(BAT) ratio was 68.05 according to a multivariate model (P = 0.0005). Thus, the kan-l(BAT) ratio may serve as a new molecular prognostic marker in HCC patients, following hepatic resection. 96363980 Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure Ellis A.J.; Hughes R.D.:Wendon J.A.;Dunne J.;Langley P.G.; Kelly J.H.; Gislason G.T.; Sussman N.L.; Williams R. Institute of’ Liver Studies, King’s Coil. School of Medicine/Dentistry, Bessemer Rd., London SE5 9PJ HEPATOLOGY 1996 2416 (144661451) The objective of this pilot controlled study was to evaluate the extracorporeal liver assist device (ELAD) in patients with acute liver failure who were judged to still have a significant chance of survival ( - 50%) and in those who had already fulfilled criteria for transplantation. Patients. 24, were divided into two groups, 17 with a potentially recoverable lesion (group I) and 7 listed for transplantation (group II), and then randomly allocated to ELAD haemoperfusion or control. The median period of ELAD haemoperfusion was 72 h (range 3- 168 h). Biocompatibility of the device was good, with no acceleration in platelet consumption, and haemodynamic stability was maintained. Two patients were withdrawn from the study because of worsening of preexisting disseminated intravascular coagulation in one case and a hypersensitivity reaction in the other. Deterioration with respect to encephalopathy grade was more frequent in the control patients, 7 of 12 (58%) than in the ELAD-treated patients, 3 of 12 (25%). In group I where survival for the ELAD cases was 7 of 9 (78%) there was a higher than expected survival in the controls, 6 of 8 (75%). For group II cases, survival was 1 of 3 (33”/1) for the ELAD-treated patients, and 1 of 4 (25%) for the controls. Both of the survivors underwent transplantation. Assessment of additive function for the device revealed an improvement in galactose elimination capacity after 6 h of haemoperfusion. Based on the results of this pilot-controlled trial, better indices of prognosis will be required, in addition to those used to select for transplantation, if patients at an earlier stage of clinical deterioration are to be included in future studies. 9636398 1 What constitutes long term survival after surgery for hilar cholangiocarcinoma? Klempnauer J.; Ridder G.J.; Werner M.; Weimann A.; Pichlmayr R. KA T, Medizinishe Hochschule Hannover, D -30 623 Hunnover CANCER 1997 79/l (26-34) Background: Hilar cholangiocarcinomas are rarely considered to be respectable and specific data regarding long term survival are not available. Methods: A retrospective single center experience from 1971 and 1995 details long term survival among 339 patients who underwent surgery for adenocarcinema of the hepatic duct bifurcation. Tumor removal was accomplished by resection of the bile duct bifurcation either alone (33 patients), in combination with hepatic resection (77 patients), or combined