The Role of Endotoxin Removal Therapy for Treatment of Severe Sepsis in Living Donor Liver Transplantation
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Accession number;07A0029725
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| Title;The Role of Endotoxin Removal Therapy for Treatment of Severe Sepsis in Living Donor Liver Transplantation |
| Author;
KOZAKI KOICHI
(Kyoto Univ., Fac. Medicine, JPN)
ISHIZAKI MORIHIKO
(Kyoto Univ., Fac. Medicine, JPN)
EGAWA HIROTO
(Kyoto Univ., Fac. Medicine, JPN)
TAKADA YASUTSUGU
(Kyoto Univ., Fac. Medicine, JPN)
SEGAWA HAJIME
(Kyoto Univ. Hospital, JPN)
UEMOTO SHINJI
(Kyoto Univ., Fac. Medicine, JPN)
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Journal Title;Ther Res
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Journal Code:Y0681A
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ISSN:0289-8020
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VOL.27;NO.12;PAGE.2275-2286(2006)
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| Figure&Table&Reference;FIG.6, TBL.2, REF.11 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Endotoxin (ET) is lipopolysaccaride (LPS) that composes cell membrane of Gram-negative rod bacillus. ET causes the endotoxin shock (Septic shock: ET-S) from the endotoxemia. Endotoxin removal therapy (PMX) used by column containing polymyxin B immobilized fiber is useful for the treatment of the patients with ET-S by adsorbing LPS. On the other hand, the effect might not necessarily correlate to the ET in blood, not rise the ET concentration on an effective case, and be made the contradiction point of PMX. Three living donor liver transplant adult cases were performed PMX after operation caused by septic shock in our hospital. Two of 3 cases have already been in multiple organ failure when PMX have started, and lifesaving cannot have been done though the circulation state has been improved temporarily by PMX. Moreover, the circulation state has been improved temporarily by PMX though 1 case has been in a septic shock caused by Gram-positive coccus bacillus. PMX has been able to be done also to the living donor liver transplantation under severe liver failure. As PMX was useful for stabilizing the circulation state, PMX enabled the other hemopurification therapy including continuous hemodiafiltration (CHDF) under ET-S. Furthermore, PMX was useful for septic shock caused by Gram-positive coccus bacillus. In this article, we described the indication, the effect, and the timing of PMX in the living donor liver transplantation. (author abst.) |
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