However, until now, the device s effectiveness had not been compared to standard care in a large number of cirrhotic patients who develop acute hepatic encephalopathy. This neurological disorder stems from toxins mainly ammonia arising from the gastrointestinal tract that bypass the damaged liver and go directly to the brain. There they can disrupt neurotransmitter function, causing mental deterioration, including coma. Standard medical care for acute hepatic encephalopathy involves treating the patient with lactulose, a non-absorbable liquid that eliminates ammonia along with stool. Six out of 10 times, it relieves the encephalopathy.
Standard therapy takes about five days to work.
He and colleagues at UNC-CH, the Mayo Clinic, the University of Colorado Health Sciences and the Medical College of Virginia Hospitals will enroll 200 patients. They will be randomized to receive either three dialysis treatments or standard medical therapy. Researchers expect that many patients will be drawn from the liver transplant waiting list. All patients will have been diagnosed with at least stage 2 acute hepatic encephalopathy based on a scale of 0 to 4 wherein 0 equals normal and 4 equals coma. These may include gastrointestinal bleeding or bleeding internally, infection, dehydration, not taking medication properly or a high protein diet.