E-ISSN: 2149-6048 ISSN: 2149-5807
Experience of Treatments of Amanita Phalloides-induced Fulminant Liver Failure with Molecular Adsorbent Recirculating System and Therapeutic Plasma Exchange
PDF
Cite
Share
Request
Original Article
VOLUME: 13 ISSUE: 4
P: 181-186
December 2014

Experience of Treatments of Amanita Phalloides-induced Fulminant Liver Failure with Molecular Adsorbent Recirculating System and Therapeutic Plasma Exchange

Eurasian J Emerg Med 2014;13(4):181-186
DOI: 10.5152/jaem.2014.75608
Chunting Wang 1
Jicheng Zhang 1
Ying Zhang 2
Zhiyong Peng 3
Xueqiang Xueqiang 4
Pengfei Bian 2
Wenjuan Ma 2
Chengyong Qin 1
1. Department of Critical Care Medicine, Provincial Hospital Affiliated Shandong University, Jinan, China
2. Jinan Infectious Disease Hospital, Shandong University, Jinan, China
3. Center of Critical Care Nephrology, The Crisma (Clinical Research, Investigation and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
4. Juxian Center for Disease Prevention and Control, Shandong, China
No information available.
No information available
Received Date: 16.01.2014
Accepted Date: 18.01.2014
PDF
Cite
Share
Request

ABSTRACT

Objective:

To evaluate the effects of molecular adsorbent recirculating system (MARS) and therapeutic plasma exchange (TPE) on patients with amanita phalloides- induced fulminant liver failure.

Material and Methods:

We retrospectively analyzed nine cases of amanita phalloides poisoning where MARS and/or TPE was applied.

Results:

The survival rate for the nine patients in this study was 66.7%. Patients who received both MARS and TPE therapies experienced higher survival rates than those who received MARS or TPE alone (100% vs 0%, 50%). A single session of TPE produced greater improvements in ALT (-58.6% vs -12.5%), AST (-44.2% vs -26.9%), total bilirubin (-44.4% vs -12.5%), and PT (-51.2% vs -4.89%) compared to a single session of MARS (all p<0.05).

Conclusion:

The results suggest that TPE has better efficacy in removing toxins and improving liver functions. There is a trend that combined use of MARS and TPE may be more effective than either therapy alone, and early intervention may be more effective than delayed therapy. Additionally, the presence of severe hypoglycemia, severe liver failure, and renal failure indicated a worse outcome.