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Ocskay K, Tomescu D, Faltlhauser A, et al. Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry. J Clin Med. 2021;10(21)doi: 10.3390/jcm10215182.
Ocskay, K., Tomescu, D., Faltlhauser, A., Jacob, D., Friesecke, S., Malbrain, M., Kogelmann, K., Bogdanski, R., Bach, F., Fritz, H., Hartjes, A., Kortgen, A., Soukup, J., Utzolino, S., van Tellingen, M., Träger, K., Schumacher, U., Brunkhorst, F. M., & Molnar, Z. (2021). Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry. Journal of clinical medicine, 10(21), . https://doi.org/10.3390/jcm10215182
Ocskay, Klementina, et al. "Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry." Journal of clinical medicine vol. 10,21 (2021). doi: https://doi.org/10.3390/jcm10215182
Ocskay K, Tomescu D, Faltlhauser A, Jacob D, Friesecke S, Malbrain M, Kogelmann K, Bogdanski R, Bach F, Fritz H, Hartjes A, Kortgen A, Soukup J, Utzolino S, van Tellingen M, Träger K, Schumacher U, Brunkhorst FM, Molnar Z. Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry. J Clin Med. 2021 Nov 05;10(21). doi: 10.3390/jcm10215182. PMID: 34768702; PMCID: PMC8584981.
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J Clin Med. 2021 Nov 05;10(21). doi: 10.3390/jcm10215182.

Hemoadsorption in 'Liver Indication'-Analysis of 109 Patients' Data from the CytoSorb International Registry.

Journal of clinical medicine

Klementina Ocskay, Dana Tomescu, Andreas Faltlhauser, David Jacob, Sigrun Friesecke, Manu Malbrain, Klaus Kogelmann, Ralph Bogdanski, Friedhelm Bach, Harald Fritz, Andreas Hartjes, Andreas Kortgen, Jens Soukup, Stefan Utzolino, Martijn van Tellingen, Karl Träger, Ulrike Schumacher, Frank M Brunkhorst, Zsolt Molnar

Affiliations

  1. Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.
  2. Anesthesiology and Intensive Care, Fundeni Clinical Institute, 022328 Bucharest, Romania.
  3. Medizinische Klinik I, Kliniken Nordoberpfalz AG, Klinikum Weiden, 92637 Weiden, Germany.
  4. Klinik für Anaesthesiologie und Intensivtherapie, Universitätsklinikum Magdeburg, 39120 Magdeburg, Germany.
  5. Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
  6. Intensive Care Chief Medical Officer, AZ Jan Palfijn, 9000 Gent, Belgium.
  7. First Department of Anaesthesia and Intensive Therapyx, Medical University of Lublin, 20059 Lublin, Poland.
  8. Hans-Susemihl-Krankenhaus GmbH, Klinik für Anästhesiologie und Intensivmedizin, 26721 Emden, Germany.
  9. Klinikum Rechts der Isar der TU München, Klinik für Anästhesiologie, 81675 München, Germany.
  10. Evangelisches Krankenhaus Bielefeld, Klinik für Anästhesiologie, Intensiv-, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Kantensiek 11, 33617 Bielefeld, Germany.
  11. Krankenhaus Martha Maria Halle, Klinik für Anaesthesiologie und Intensivmedizin, Röntgenstr. 1, 06120 Halle, Germany.
  12. Krankenhaus der Barmherzigen Schwestern Ried, Anästhesie, Intensiv- und Palliativmedizin, Schlossberg 1, 4933 Ried im Innkreis, Austria.
  13. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, 07747 Jena, Germany.
  14. Carl-Thiem-Klinikum Cottbus, Klinik für Anästhesiologie, Intensivtherapie und Palliativmedizin, Thiemstr. 111, 03048 Cottbus, Germany.
  15. Abteilung Allgemein- und Viszeralchirurgie, Universitätsklinikum Freiburg, 79106 Freiburg, Germany.
  16. Intensive Care, Ziekenhuis de Tjongerschans, 8441 PW Heerenveen, The Netherlands.
  17. Kardioanasthesiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
  18. Zentrum für Klinische Studien, Universitätsklinikum Jena, 07747 Jena, Germany.
  19. Zentrum für Klinische Studien, Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany.
  20. Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Poznan University for Medical Sciences, 60355 Poznan, Poland.
  21. Department of Anaesthesiology and Intensive Therapy, Semmelweis University, 1082 Budapest, Hungary.

PMID: 34768702 PMCID: PMC8584981 DOI: 10.3390/jcm10215182

Abstract

BACKGROUND: Our aim is to report the results of the 'liver indication' subset of patients in the CytoSorb International Registry.

METHODS: Structured data were recorded. Treatment characteristics and changes from T1 (start of hemoadsorption) to T2 (termination) were evaluated with a special focus on bilirubin, C-reactive protein, procalcitonin, interleukin-6, platelet levels, SOFA scores, mortality, and subjective assessment by the attending physicians.

RESULTS: Until January 2021, from the total 1434 patients, 109 (age: 49.2 ± 17.1 years, 57.8% males) received treatment for hyperbilirubinemia. APACHE II-predicted mortality was 49.6 ± 26.8%. In the study, 91% of patients were alive at the termination of hemoadsorption and improvement was observed by the physicians in 75 cases. Overall, 65 (59.6%) patients died in the hospital, and 60 (55.0%) died in the ICU. Patients received a median of two treatments for a median of 43 h (interquartile range: 24-72 h) in total. Serum bilirubin levels reduced significantly to -4.6 (95% CI: -6.329 to -2.8) mg/dL. Thrombocytopenia was reported in four patients as an adverse event.

CONCLUSIONS: We report the largest case series on hemoadsorption for 'liver indication' from the CytoSorb International Registry. The finding of significant bilirubin removal observed in our study could have substantial impact in designing and executing further studies on the effects of hemoadsorption in liver dysfunction, which are certainly warranted.

Keywords: CytoSorb; bilirubin; blood purification; cytokine adsorption; hemoadsorption; liver failure; liver support

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