Successful use of single‐pass albumin dialysis in the correction of severe hyperbilirubinemia in a case of acute hepatitis E. Issue 2 (25th July 2022)

• Record Type: Journal Article
• Authors: Piscitani, Luca; Di Vito, Roberto; Tunno, Marilena; Bonomini, Mario
• Is Part Of: Therapeutic apheresis and dialysis. Volume 27:Issue 2(2023)
• Page Start: 278
• Page End: 283
• Publication Date: 2022-07-25
• Subjects: acute liver failure -- albumin dialysis -- hepatitis E virus -- hyperbilirubinemia -- SPAD; Hemapheresis -- Periodicals; Dialysis -- Periodicals; Blood Component Removal -- Periodicals; Renal Dialysis -- Periodicals; Hémaphérèse -- Périodiques; Dialyse -- Périodiques; Sang -- Collecte et conservation -- Périodiques; 616
• DOI: 10.1111/1744-9987.13909
• Languages: English
• ISSNs: 1744-9979

Abstract

Abstract: Introduction: Acute liver failure (ALF) is a rare syndrome defined by the rapid loss of liver function in the absence of pre‐existing liver disease, which may be secondary to hepatitis A virus, hepatitis E virus (HEV), or to drugs in about 50% of cases. Extracorporeal albumin dialysis enables the elimination of albumin‐bound toxins that accumulate in liver failure. Methods: We report a case of ALF secondary to HEV associated with severe hyperbilirubinemia. Patient was treated with four consecutive sessions of single‐pass albumin dialysis (SPAD) carried out setting the following parameters: time: 300 min, Qb: 60 mL/min, Qd: 800–1000 mL/min, dialysate containing 4% albumin, citrate: 3–4 mmol/L. Result: SPAD documented good support of liver function. Bilirubin levels were reduced from 22 to 14 g/dL after four treatments. Pruritus was the first clinical sign of improvement. Conclusion: SPAD system can represent a safe and effective therapeutic option.