Extracorporeal blood purification in patients with liver failure: Considerations for the low-and-middle income countries of Latin America.

Autor:	Villanueva VB; Division of Nephrology, Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad 14, Universidad Veracruz, Veracruz, Mexico., Barrera Amorós DA; Division of Nephrology, Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad 14, Universidad Veracruz, Veracruz, Mexico., Castillo Echeverria EI; Nephrologist, Instituto Mexicano del Seguro Social, Hospital General de Zona 71, Veracruz, Mexico., Budar-Fernández LF; Division of Nephrology, Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad 14, Universidad Veracruz, Veracruz, Mexico., Salas Nolasco OI; Nephrologist, Hospital Español de Veracruz, Veracruz, Mexico., Juncos LA; Division of Nephrology, Central Arkansas Veterans Healthcare System and the University of Arkansas for Medical Sciences, Little Rock, Arkansas, EUA, United States., Rizo-Topete L; Division of Nephrology, Hospital Unniversitario 'Dr. José Eleuterio Gonzalez', Universidad Autónoma de Nuevo León (UANL), Nuevo León, Mexico.; Division Internal Medicine, Hospital Christus Muguerza Alta Especialidad, Universidad de Monterrey (UDEM), Monterrey, Nuevo Leon, Mexico.
Jazyk:	angličtina
Zdroj:	Frontiers in nephrology [Front Nephrol] 2023 Jan 31; Vol. 3, pp. 938710. Date of Electronic Publication: 2023 Jan 31 (Print Publication: 2023).
DOI:	10.3389/fneph.2023.938710
Abstrakt:	Severe liver failure is common in Low-and-Medium Income Countries (LMIC) and is associated with a high morbidity, mortality and represents an important burden to the healthcare system. In its most severe state, liver failure is a medical emergency, that requires supportive care until either the liver recovers or a liver transplant is performed. Frequently the patient requires intensive support until their liver recovers or they receive a liver transplant. Extracorporeal blood purification techniques can be employed as a strategy for bridging to transplantation or recovery. The most common type of extracorporeal support provided to these patients is kidney replacement therapy (KRT), as acute kidney injury is very common in these patients and KRT devices more readily available. However, because most of the substances that the liver clears are lipophilic and albumin-bound, they are not cleared effectively by KRT. Hence, there has been much effort in developing devices that more closely resemble the clearance function of the liver. This article provides a review of various non-biologic extracorporeal liver support devices that can be used to support these patients, and our perspective keeping in mind the needs and unique challenges present in the LMIC of Latin America. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Villanueva, Barrera Amorós, Castillo Echeverria, Budar-Fernández, Salas Nolasco, Juncos and Rizo-Topete.)
Databáze:	MEDLINE
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