Observational studyJournal of nephrology2021
Detoxification of bilirubin and bile acids with intermittent coupled plasmafiltration and adsorption in liver failure (HERCOLE study).
Observational study in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- A safe and effective protocol for postdilution hemofiltration with regional citrate anticoagulation.BMC nephrology · 2024Trial
- Cast nephropathy in the ICU: Early recognition and extracorporeal strategies to improve outcomes.Journal of intensive medicine · 2026Review
- Validation of Hemoglobin and Hematocrit Measurements from a Dialysis Machine Sensor Compared to Laboratory Analysis.Journal of clinical medicine · 2025Article
- Efficacy of a novel artificial liver versatile plasma purification system in patients with acute-on-chronic liver failure.World journal of gastroenterology · 2025Article
- Bilirubin Removal with Therapeutic Plasma Exchange or Molecular Adsorbent Recirculating System as Treatment for Cholemic Nephropathy in Patients with Cirrhosis and Acute-on-Chronic Liver Failure: A Case Series.Blood purification · 2025Article
- Artificial liver classifier: a new alternative to conventional machine learning models.Frontiers in artificial intelligence · 2025Article
- Article
- Hemoadsorption in Organ Preservation and Transplantation: A Narrative Review.Life (Basel, Switzerland) · 2023Review
- [Hemoperfusion in anesthesia and intensive care medicine: benefits, risks, and evidence for different systems].Die Anaesthesiologie · 2023Review
- Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study.Annals of intensive care · 2023Article
- Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions.World journal of clinical cases · 2023Review
- [Clinical study of heparin anticoagulation scheme during plasma adsorption therapy for liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Liver failure-future challenges and remaining questions.Annals of translational medicine · 2021Review
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCPFA is an extracorporeal treatment used in severe sepsis to remove circulating proinflammatory cytokines. Limited evidence exists on the effectiveness of bilirubin adsorption by the hydrophobic styrenic resin, the distinctive part of CPFA. The aim of this study is to validate CPFA effectiveness in liver detoxification.
methodsIn this prospective observational study, we enrolled patients with acute or acute-on-chronic liver failure (serum total bilirubin > 20 mg/dL or MELD Score > 20) hospitalized from June 2013 to November 2017. CPFA was performed using the Lynda (Bellco/MedTronic, Mirandola, Italy) or the Amplya (Bellco/MedTronic, Mirandola, Italy) machines. Anticoagulation was provided with unfractionated heparin or citrate. Bilirubin and bile acids reduction ratios per session (RRs) were the main parameters for hepatic detoxification.
resultsTwelve patients with acute (n = 3) or acute-on-chronic (n = 9) liver failure were enrolled. Alcohol was the main cause of liver disease. Thirty-one CPFA treatments of 6 h each were performed, 19 with heparin and 12 with citrate. RRs was 28.8% (range 2.2-40.5) for total bilirubin, 32.7% (range 8.3-48.9) for direct bilirubin, 29.5% (range 6.5-65.4) for indirect bilirubin and 28.9% (16.7- 59.7) for bile acids. One patient received liver transplantation and 8/9 were alive at 1 year of follow-up. Three patients (25%) died: 2 during hospitalization and 1 for a cardiac event at 4 months of follow up with restored liver function.
conclusionsCPFA resulted to be effective in liver detoxification. Thus, it may be considered as a "bridge technique" both to the liver transplant and to the recovery of the basal liver function.
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