Prospective, randomized, multicenter, controlled trial of a bioartificial liver in treating acute liver failure.

Abstract:

OBJECTIVE:The HepatAssist liver support system is an extracorporeal porcine hepatocyte-based bioartificial liver (BAL). The safety and efficacy of the BAL were evaluated in a prospective, randomized, controlled, multicenter trial in patients with severe acute liver failure. SUMMARY BACKGROUND DATA:In experimental animals with acute liver failure, we demonstrated beneficial effects of the BAL. Similarly, Phase I trials of the BAL in acute liver failure patients yielded promising results. METHODS:A total of 171 patients (86 control and 85 BAL) were enrolled. Patients with fulminant/subfulminant hepatic failure and primary nonfunction following liver transplantation were included. Data were analyzed with and without accounting for the following confounding factors: liver transplantation, time to transplant, disease etiology, disease severity, and treatment site. RESULTS:For the entire patient population, survival at 30 days was 71% for BAL versus 62% for control (P = 0.26). After exclusion of primary nonfunction patients, survival was 73% for BAL versus 59% for control (n = 147; P = 0.12). When survival was analyzed accounting for confounding factors, in the entire patient population, there was no difference between the 2 groups (risk ratio = 0.67; P = 0.13). However, survival in fulminant/subfulminant hepatic failure patients was significantly higher in the BAL compared with the control group (risk ratio = 0.56; P = 0.048). CONCLUSIONS:This is the first prospective, randomized, controlled trial of an extracorporeal liver support system, demonstrating safety and improved survival in patients with fulminant/subfulminant hepatic failure.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Demetriou AA,Brown RS Jr,Busuttil RW,Fair J,McGuire BM,Rosenthal P,Am Esch JS 2nd,Lerut J,Nyberg SL,Salizzoni M,Fagan EA,de Hemptinne B,Broelsch CE,Muraca M,Salmeron JM,Rabkin JM,Metselaar HJ,Pratt D,De La Mata M,Mc

doi

10.1097/01.sla.0000124298.74199.e5

subject

Has Abstract

pub_date

2004-05-01 00:00:00

pages

660-7; discussion 667-70

issue

5

eissn

0003-4932

issn

1528-1140

pii

00000658-200405000-00010

journal_volume

239

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
  • Specialty networking in pediatric surgery: a paradigm for the future of academic surgery.

    abstract:OBJECTIVE:To review retrospectively a 4-year experience with pediatric surgical networking at a major academic medical center in the Midwest. BACKGROUND:The growth of managed care in the United States during the past decade has had a major impact on the practice of medicine in general, but especially on academic medic...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199909000-00006

    authors: Coran AG,Blackman PM,Sikina C,Harmon CM,Lelli JL Jr,Geiger JD,Hirschl RB,Teitelbaum DH,Polley TZ Jr,Golladay ES,Austin E,Adelman SH

    更新日期:1999-09-01 00:00:00

  • The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice.

    abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e3e411

    authors: Ayazi S,Tamhankar A,DeMeester SR,Zehetner J,Wu C,Lipham JC,Hagen JA,DeMeester TR

    更新日期:2010-07-01 00:00:00

  • Lymphedema after complete axillary node dissection for melanoma: assessment using a new, objective definition.

    abstract:OBJECTIVES:The objectives of this study were to define appropriate criteria for assessing the presence of lymphedema, and to report the prevalence and risk factors for development of upper limb lymphedema after level I-III axillary dissection for melanoma. SUMMARY BACKGROUND DATA:The lack of a consistent and reliable ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000143271.32568.2b

    authors: Starritt EC,Joseph D,McKinnon JG,Lo SK,de Wilt JH,Thompson JF

    更新日期:2004-11-01 00:00:00

  • How Much Weight Loss is Required for Cardiovascular Benefits? Insights From a Metabolic Surgery Matched-cohort Study.

    abstract:OBJECTIVE:The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE). BACKGROUND:Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovas...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004369

    authors: Aminian A,Zajichek A,Tu C,Wolski KE,Brethauer SA,Schauer PR,Kattan MW,Nissen SE

    更新日期:2020-10-01 00:00:00

  • Treatment of 27 postoperative enterocutaneous fistulas with the long half-life somatostatin analogue SMS 201-995.

    abstract::Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients h...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198907000-00009

    authors: Nubiola P,Badia JM,Martinez-Rodenas F,Gil MJ,Segura M,Sancho J,Sitges-Serra A

    更新日期:1989-07-01 00:00:00

  • Incidence of anatomical variants in renal vasculature in the presence of normal renal function.

    abstract::This report defines the incidence of variations in the renal vascular pedicle in a group of patients with normal renal function as determined by standard laboratory criteria. The study group consisted of 166 patients undergoing renal arteriography as potential renal allograft donors. Ninety-seven patients were male an...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197807000-00014

    authors: Harrison LH Jr,Flye MW,Seigler HF

    更新日期:1978-07-01 00:00:00

  • HER-3 overexpression is prognostic of reduced breast cancer survival: a study of 4046 patients.

    abstract:INTRODUCTION:Advances in molecular biology have led to the identification of potential markers of prognostic and therapeutic importance in human cancers. HER-2 testing and targeted therapy now represents a critical cornerstone in the management of breast cancer. The objectives of the current study were to determine the...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181dbb77e

    authors: Chiu CG,Masoudi H,Leung S,Voduc DK,Gilks B,Huntsman DG,Wiseman SM

    更新日期:2010-06-01 00:00:00

  • Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial (PROPP Study, DRKS00004191).

    abstract:OBJECTIVES:The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND:PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard proce...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000002480

    authors: Hackert T,Probst P,Knebel P,Doerr-Harim C,Bruckner T,Klaiber U,Werner J,Schneider L,Michalski CW,Strobel O,Ulrich A,Diener MK,Büchler MW

    更新日期:2018-06-01 00:00:00

  • The 30-day versus in-hospital and 90-day mortality after esophagectomy as indicators for quality of care.

    abstract:OBJECTIVE:To describe causes of death in the first year after esophagectomy and determine the time frame that should be used for measurement of quality of surgery. A case-mix adjustment model was developed for the comparison between hospitals. BACKGROUND:The time period in which postoperative mortality should be measu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000482

    authors: Talsma AK,Lingsma HF,Steyerberg EW,Wijnhoven BP,Van Lanschot JJ

    更新日期:2014-08-01 00:00:00

  • Inhalation injury severity and systemic immune perturbations in burned adults.

    abstract:OBJECTIVE:We aimed to determine whether the severity of inhalation injury evokes an immune response measurable at the systemic level and to further characterize the balance of systemic pro- and anti-inflammation early after burn and inhalation injury. BACKGROUND:Previously, we reported that the pulmonary inflammatory ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318275f424

    authors: Davis CS,Janus SE,Mosier MJ,Carter SR,Gibbs JT,Ramirez L,Gamelli RL,Kovacs EJ

    更新日期:2013-06-01 00:00:00

  • Prospective study of eukaryotic initiation factor 4E protein elevation and breast cancer outcome.

    abstract:OBJECTIVE:To validate the authors' initial hypothesis-generating observation that eukaryotic initiation factor 4E (eIF4E) protein elevation predicts a higher cancer recurrence rate in patients with stage 1 to 3 breast cancer. SUMMARY BACKGROUND DATA:Tumor size and nodal status continue to be the two most important ind...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200205000-00016

    authors: Li BD,Gruner JS,Abreo F,Johnson LW,Yu H,Nawas S,McDonald JC,DeBenedetti A

    更新日期:2002-05-01 00:00:00

  • Pseudomonas aeruginosa expresses a lethal virulence determinant, the PA-I lectin/adhesin, in the intestinal tract of a stressed host: the role of epithelia cell contact and molecules of the Quorum Sensing Signaling System.

    abstract:OBJECTIVE:We have previously demonstrated that P. aeruginosa can have profound effects on the intestinal epithelial barrier via one of its virulence factors, the PA-I lectin/adhesin. The aims of the present study were to further characterize the interaction of P. aeruginosa and the intestinal epithelium using both in v...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000094551.88143.f8

    authors: Wu L,Holbrook C,Zaborina O,Ploplys E,Rocha F,Pelham D,Chang E,Musch M,Alverdy J

    更新日期:2003-11-01 00:00:00

  • Human umbilical veins and autogenous veins as canine arterial bypass grafts.

    abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197808000-00005

    authors: Oblath RW,Buckley FO Jr,Donnelly WA,Green RM,Deweese JA

    更新日期:1978-08-01 00:00:00

  • Platelet-rich fibrin versus albumin in surgical wound repair: a randomized trial with paired design.

    abstract:OBJECTIVE:To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial. SUMMARY BACKGROUND DATA:Platelet peptidic growth factors may stimulate colla...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181d3548c

    authors: Danielsen PL,Agren MS,Jorgensen LN

    更新日期:2010-05-01 00:00:00

  • Prognostic Implications of Pathological Response to Neoadjuvant Chemoradiation in Pathologic Stage III Rectal Cancer.

    abstract:OBJECTIVE:To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND:Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in recta...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002719

    authors: Karagkounis G,Thai L,Mace AG,Wiland H,Pai RK,Steele SR,Church JM,Kalady MF

    更新日期:2019-06-01 00:00:00

  • Clinical effect of allopurinol on preserved kidneys: a randomized double-blind study.

    abstract::We investigated the clinical posttransplant effect of allopurinol on preserved kidneys. Thirty-four paired kidneys from brain-dead cadavers were preserved by hypothermic pulsatile perfusion with silica gel fraction in separate cassettes. Allopurinol was added to one perfusate and omitted from the other in a randomized...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-197701000-00021

    authors: Toledo-Pereyra LH,Simmons RL,Olson LC,Najarian JS

    更新日期:1977-01-01 00:00:00

  • Proficiency of surgeons in inguinal hernia repair: effect of experience and age.

    abstract:OBJECTIVES:We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. SUMMARY BACKGROUND DATA:In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant diffe...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.sla.0000179644.02187.ea

    authors: Neumayer LA,Gawande AA,Wang J,Giobbie-Hurder A,Itani KM,Fitzgibbons RJ Jr,Reda D,Jonasson O,CSP #456 Investigators.

    更新日期:2005-09-01 00:00:00

  • Multiple cutaneous malignant melanomas with features of primary melanoma.

    abstract::A case report and review of the literature regarding multiple primary melanomas, and a discussion of the histologic differentiation between cutaneous primary melanomas and dermal metastases are presented. This report concerns a patient who, following wide surgical resection of a 1.3 mm thick primary melanoma with sate...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198102000-00021

    authors: Unger SW,Wanebo HJ,Cooper PH

    更新日期:1981-02-01 00:00:00

  • The operative treatment of Crohn's enteritis complicated by ileosigmoid fistula.

    abstract::An ileosigmoid fistula complicating Crohn's disease of the small bowel has been considered a perplexing entity, but in practice does not pose a serious operative problem. The presence of such a fistula does not signify that the sigmoid colon is a primary site of Crohn's disease. The operative treatment of this entity ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198209000-00015

    authors: Block GE,Schraut WH

    更新日期:1982-09-01 00:00:00

  • Pathogenicity of the enterococcus in surgical infections.

    abstract::The enterococcus has been relegated to a position of unimportance in the pathogenesis of surgical infections. However the increasing prevalence and virulence of these bacteria prompt reconsideration of this view, particularly because the surgical patient has become increasingly vulnerable to infectious morbidity due t...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199008000-00007

    authors: Barie PS,Christou NV,Dellinger EP,Rout WR,Stone HH,Waymack JP

    更新日期:1990-08-01 00:00:00

  • The 100 Most Cited Papers in the History of the American Surgical Association.

    abstract:OBJECTIVE:The aim of this study was to determine characteristics of the most cited publications in the history of the American Surgical Association (ASA). SUMMARY BACKGROUND DATA:The Annals of Surgery has served as the journal of record for the ASA since 1928, with a special issue each year dedicated to papers present...

    journal_title:Annals of surgery

    pub_type: 历史文章,杂志文章

    doi:10.1097/SLA.0000000000003633

    authors: Landreneau JP,Weaver M,Delaney CP,Aminian A,Dimick JB,Lillemoe KD,Schauer PR

    更新日期:2020-04-01 00:00:00

  • Clinical characteristics and current management of medically refractory unstable angina.

    abstract::Of 531 patients admitted to the Duke Coronary Care Unit with unstable angina (UA) from June 1981 to September 1982, 100 had persistent angina despite optimal medical therapy of nitrates, propranolol, and nifedipine. At catheterization, 70% of the refractory patients had left main (LM) or three-vessel disease (TVD), 68...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198410000-00007

    authors: Rankin JS,Newton JR Jr,Califf RM,Jones RH,Wechsler AS,Oldham HN Jr,Wolfe WG,Lowe JE

    更新日期:1984-10-01 00:00:00

  • Twenty-five-year follow-up for liver resection: the personal series of Dr. Joseph G. Fortner.

    abstract:BACKGROUND:Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. METHODS:Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. RESULTS:All patients were followed for at least 15 years after surgery...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b59491

    authors: Fortner JG,Fong Y

    更新日期:2009-12-01 00:00:00

  • Multiple cytokines are required to induce hepatocyte nitric oxide production and inhibit total protein synthesis.

    abstract::The etiology and mechanisms by which severe trauma or sepsis induce hepatic failure are unknown. Previously we showed that Kupffer cells (KC), the fixed macrophages of the liver, induce a profound decrease in hepatocyte (HC) total-protein synthesis when exposed to endotoxin. Furthermore we demonstrated that endotoxin-...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199010000-00009

    authors: Curran RD,Billiar TR,Stuehr DJ,Ochoa JB,Harbrecht BG,Flint SG,Simmons RL

    更新日期:1990-10-01 00:00:00

  • The role of antiplatelet drugs in carotid reconstructive surgery.

    abstract::Neurologic events following carotid reconstructive surgery for symptomatic cerebral occlusive disease are generally reported to be one to two per cent. One of the events leading to this incidence is thrombosis of the endarterectomized internal carotid artery (ICA) after surgery. Since antiplatelet drugs have been foun...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198506000-00014

    authors: Edwards WH,Edwards WH Jr,Mulherin JL Jr,Jenkins JM

    更新日期:1985-06-01 00:00:00

  • Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor.

    abstract:OBJECTIVE:To assess a technique for simultaneous recovery of the intestine, pancreas, and liver from the same donor. SUMMARY BACKGROUND DATA:With the more frequent use of pancreatic and intestinal transplantation, a procurement procedure is needed that permits retrieval of both organs as well as the liver from the sam...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200011000-00010

    authors: Abu-Elmagd K,Fung J,Bueno J,Martin D,Madariaga JR,Mazariegos G,Bond G,Molmenti E,Corry RJ,Starzl TE,Reyes J

    更新日期:2000-11-01 00:00:00

  • Surgical management of bleeding chronic peptic ulcer. A 10-year prospective study.

    abstract::Analysis of experience with chronic bleeding peptic ulcer in 504 patients, admitted from 1960 to 1971, shows a hospital mortality of 12%. This retrospective review suggested that early endoscopic diagnosis, adequate resuscitation and a policy of early selective surgery was necessary if mortality was to be reduced. Wit...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198401000-00008

    authors: Hunt PS

    更新日期:1984-01-01 00:00:00

  • Aneurysm of sinus of Valsalva with coronary atherosclerosis: successful surgical correction.

    abstract::A case of acquired aneurysm of the sinus of Valsalva, associated with severe coronary atherosclerosis and successfully treated surgically, is reported. The unusual features of the case are the presenting symptom (angina pectoris) and the cause of the aneurysm (severe coronary atherosclerosis). ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197903000-00008

    authors: Debakey ME,Lawrie GM

    更新日期:1979-03-01 00:00:00

  • Popliteal artery puncture in the assessment of patients with severe leg ischemia.

    abstract::Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation vessels and the poplitea...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198312000-00017

    authors: Agerskov K,Faris I,Tønnesen KH,Kristensen P,Christensen SC

    更新日期:1983-12-01 00:00:00

  • Functional Trajectories Before and After Major Surgery in Older Adults.

    abstract:OBJECTIVES:We hypothesized that distinct sets of functional trajectories can be identified in the year before and after major surgery, with unique transition probabilities from pre to postsurgical functional trajectories, and that outcomes would be better among participants undergoing elective versus nonelective surger...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002659

    authors: Stabenau HF,Becher RD,Gahbauer EA,Leo-Summers L,Allore HG,Gill TM

    更新日期:2018-12-01 00:00:00