Extracorporeal liver support with multipass albumin dialysis or plasmapheresis and filtering systems in acute liver failure

Circulating monocytes accelerate acute liver failure by IL-6 secretion in monkey

Acute liver failure (ALF) is associated with high mortality, and a poor understanding of the underlying pathophysiology has resulted in a lack of effective treatments so far. Here, using an amatoxin‐induced rhesus monkey model of ALF, we panoramically revealed the cellular and molecular events that lead to the development of ALF. The challenged monkeys with toxins underwent a typical course of ALF including severe hepatic injury, systemic inflammation and eventual death. Adaptive immune was not noticeably disturbed throughout the progress of ALF. A systematic examination of serum factors and cytokines revealed that IL‐6 increase was the most rapid and drastic. Interestingly, we found that IL‐6 was mainly produced by circulating monocytes. Furthermore, ablation of monocyte‐derived IL‐6 in mice decreased liver injury and systemic inflammation following chemical injection. Our findings reveal a critical role of circulating monocytes in initiating and accelerating ALF, indicating a potential therapeutic target in clinical treatment for ALF.

Non-bioartificial liver support system for treating patients with severe hepatitis: Common problems and nursing countermeasures

Non-bioartificial liver support system, a common and effective therapy to salvage patients with severe hepatitis and a temporary substitution of the liver function, may "bridge" patients to liver transplantation or recovery. However, nurses play a pivotal role in the process of non-bioartificial liver support system, so it is key for successful treatment that they are able to timely identify and effectively manage adverse reactions during the process. Given all this, this review discusses common problems and nursing countermeasures encountered during treatment with the non-bioartificial liver support system in patients with severe hepatitis, aiming at improving their capacity of detecting and dealing with adverse reactions, and thus increasing the efficacy.

Biomarkers in Hepatic Disease: A Review Focused on Critically Ill Patients

The ability to make a diagnosis early and appropriately is paramount for the survival of the critically ill ICU patient. Along with the myriad physical examination and imaging modalities available, biomarkers provide a window on the disease process. Herein we review hepatic biomarkers in the context of the critical care patient.