Plasmapheresis in the Treatment of Chronic Liver Diseases. Cirrosis
Currently the treatment of choice for critical liver failure is liver transplantation. Liver failure is treated conservatively until a matching liver donor becomes available. The therapeutic plasma exchange (TPE) plays an important role as a bridge to transplantation by removing accumulated toxins from patient plasma, as well as restoring the coagulation profile.
Based on the results of our study, we conclude that the TPE improves the liver function tests, coagulation profile and short-term survival in patients with critical liver diseases, despite the continuing poor overall survival. Hence, judicious use of the TPE is recommended as supportive therapy in the performance of liver transplantation in these patients. Randomized control trials are required to further establish the definitive role and effects of the TPE in the treatment of liver failure patients.
Por lo tanto, the picture of homeostasis disorders, leading to an increase in organ disorders, is becoming increasingly clear. Los materiales presentados indican una variedad de causas de daño hepático., pero
todos son mecanismos patogénicos combinados asociados con
la acumulación de una serie de productos tóxicos que dañan el
parénquima hepático. En este caso, se acumulan muchas sustancias patológicas, el tamaño de las moléculas que no permite su excreción por los riñones, mientras que el hígado tampoco puede destruirlos.
Por otra parte, el hecho de su acumulación sugiere que ninguna
las drogas pueden ayudarlos a salir del cuerpo.
Hasta la fecha, significant progress has been made in the treatment of
viral infections, but these drugs themselves are not safe and are not
always able to interrupt the already existing pathological liver disorders that still require the use of plasmapheresis. Por lo tanto, in all
these cases, plasmapheresis is a pathogenetically justified method
of treatment and prevention of progression of liver damage.
In such cases, it is sufficient to remove up to 1 liter of plasma
with the replacement of only crystalloid solutions for 4 such sessions of plasmapheresis, held every other day, which can be provided even in outpatient settings. En el futuro, it is necessary to
regularly repeat such courses up to two times a year. Por lo tanto, it is
possible to effectively interrupt the progression of the disease and
the transition to the development of irreversible liver damage in
cirrhosis and hepatocellular carcinoma. But even with far-reaching
processes, plasmapheresis can significantly improve the condition