ArticleArtificial organs2025
Comparison of Open Albumin Dialysis (OPAL) With Prometheus Fractionated Plasma Separation and Adsorption (FPSA) and Standard Medical Treatment for Acute-On-Chronic Liver Failure.
Article in Artificial organs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Artificial Liver Support Effectively Removes Immunosuppressive Bile Acids From Circulation in Patients With Severe Liver Failure: A Proof of Concept Study.Critical care explorations · 2026Trial
- Extracorporeal Albumin Dialysis (OPAL) as Novel Therapeutic Bridging Option in Posthepatectomy Liver Failure.Artificial organs · 2026Article
- Reply from the author to "Comparison of the liver support systems OPAL and ALBUNIQUE in critically ill patients with liver dysfunction".The International journal of artificial organs · 2026Article
- Mechanistic success and clinical neutrality: lessons from the OXICARD trial.Journal of thoracic disease · 2026Article
- Comparison of the liver support systems OPAL and ALBUNIQUE in critically ill patients with liver dysfunction.The International journal of artificial organs · 2026Article
- Plasma Adsorption Perfusion (BR-350) Versus Open Albumin Dialysis (OPAL) for Hyperbilirubinemia in Hepatic Failure in Cirrhotic Patients.Artificial organs · 2026Article
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9 authors.
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Abstract
backgroundAcute-on-chronic liver failure (ACLF) is associated with high short-term mortality of up to 40%. Albumin dialysis is a therapeutic option that can be used to bridge patients with ACLF to liver transplantation or recovery.
methodsThis retrospective cohort study was conducted to determine the effectiveness and adverse effects of open albumin dialysis (OPAL) by comparing the biochemical and clinical variables of model for end-stage liver disease (MELD)-matched ACLF patients who received one of three treatments: OPAL plus standard medical treatment (SMT; 22 patients), Prometheus dialysis fractionated plasma separation and adsorption (FPSA) plus SMT (41 patients), or hemodialysis plus SMT (24 patients) at the University Hospital Essen.
resultsOPAL treatment significantly reduced liver function tests such as bilirubin (p = 0.0001) and creatinine levels (p = 0.049). Therefore, OPAL therapy significantly reduced the MELD score (p = 0.001) and the Chronic Liver Failure Consortium (CLIF-C) ACLF (p = 0.0005) score. In both extracorporeal liver support groups, the decrease in MELD score was significantly stronger than that achieved with SMT (OPAL vs. SMT, p = 0.002; Prometheus vs. SMT, p = 0.0001; OPAL vs. Prometheus p = 0.90). In comparison to the SMT group, survival rates after 14 and 30 days were significantly higher in the Prometheus group (p = 0.0008 and 0.03) and tended to be better in the OPAL group, although statistical significance was not reached (p = 0.06 and p = 0.11).
conclusionsOur analysis revealed OPAL is an efficient method of albumin dialysis yielding a reduction of bilirubin and creatinine levels and improving clinical scoring in ACLF patients. OPAL as well as Prometheus were associated with a stronger reduction of relevant biochemical variables of liver function and amelioration in clinical scoring in comparison to SMT. However, it should be considered that patients from the SMT group were older and experienced progressive ACLF with high mortality risks compared to the patients from the OPAL and Prometheus groups. Thus, when interpreting the study results, several limitations including small sample size and heterogeneity of the treatment groups due to the lack of randomization should be taken into account.
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