metricas
covid
Buscar en
Annals of Hepatology
Toda la web
Inicio Annals of Hepatology P-3 PLASMA EXCHANGE WITH ALBUMIN INCREASES EFFECTIVE ALBUMIN LEVELS IN PATIENTS ...
Información de la revista
Vol. 28. Núm. S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(marzo 2023)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 28. Núm. S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(marzo 2023)
Acceso a texto completo
P-3 PLASMA EXCHANGE WITH ALBUMIN INCREASES EFFECTIVE ALBUMIN LEVELS IN PATIENTS WITH ACUTE-ON-CHRONIC LIVER FAILURE
Visitas
236
Raquel Horrillo1, Anna Mestre1, Alba Pérez1, Jordi Vidal1, Estefania Alcaraz1, Mireia Torres1, Vicente Arroyo2, Javier Fernández2,3, Joan Clària2,3,4, Montserrat Costa1
1 Scientific Innovation Office, Grifols, Barcelona, Spain
2 Ef Clif, Easl-Clif Consortium and Grifols Chair, Barcelona, Spain
3 Hospital Clinic, Idibaps and Ciberehd, Barcelona, Spain
4 Department of Biomedical Sciences, University of Barcelona Medical School, Barcelona, Spain
Este artículo ha recibido
Información del artículo
Suplemento especial
Este artículo forma parte de:
Vol. 28. Núm S1

Abstracts of the 2022 Annual Meeting of the ALEH

Más datos
Introduction and Objectives

Non-oncotic albumin functions such as transport, antioxidant and immunomodulatory capacities may be associated with the beneficial effects of albumin therapy in liver disease patients. For acute-on-chronic liver failure (ACLF) patients, characterized mainly by severe systemic inflammation and organ failure, plasma exchange with human serum albumin (PE-A5%) may be an effective treatment. In fact, the effects of PE-A5% on short-term survival in patients with ACLF are currently under investigation (APACHE phase 3 trial, NCT03702920). To characterize albumin levels with intact structure (effective albumin) in patients with ACLF compared with healthy controls (HC) and to assess the effect of PE-A5% treatment on eAlb levels in patients with ACLF.

Materials and Methods

Plasma samples from 10 patients included in the Pilot-APACHE trial (NCT01201720) were assessed. This was a prospective, open-label, non-controlled study in which ACLF patients were treated with six PE-A5% for 10 days. At baseline, results were compared with HC (n=10). Albumin post-translational modifications (PTMs) were determined by mass spectrometry (LC_ESI_qTOF-MS). Native albumin (%) (the primary structure preserved form without PTMs) and effective albumin levels (mg/mL) (calculated as (total albumin x native albumin)/100)) were evaluated. Results were expressed as median (IQR).

Results

At baseline, ACLF patients showed a significantly lower proportion of native albumin, 19.4% (10.0-28.5), compared with HC, 51.3% (49.0-52.6), P<0.0001. Similarly, effective albumin levels, 6.8 mg/mL (3.5-8.9), were lower than HC, 19.8 mg/mL (18.9-20.7), P<0.0001. This reduction in native albumin was associated with higher cysteinylated and glycated isoforms. After six PE-A5%, native albumin (27.6% (17.1-35.3), p=0.036) and effective albumin (10.4 mg/mL (6.4-13.8); p=0.0067) were significantly increased. Remarkably, this effect was observed right after each PE-A5% session.

Conclusions

ACLF patients presented albumin structural abnormalities that led to decreased effective albumin levels. PE-A5% not only improved non-oncotic albumin functions1 but increased structurally preserved albumin in these patients.

1J Hepatol 2018;68(Suppl1):S105-S364

El Texto completo está disponible en PDF
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos