By Hans Popper (auth.), Professor Dr. Gorig Brunner, Professor Dr. Friedrich Werner Schmidt (eds.)
The regenerative potential of the liver cellphone is nearly limitless. for this reason after acute liver harm, be it viral, poisonous, hypoxic, or surgical in foundation, restitutio advert integrum is the standard final result. In types of liver illness, although, this isn't the case: in fulmi nant hepatic failure, liver regeneration frequently isn't really quickly sufficient to maintain the organism alive; in end-stage cirrhosis, regeneration is dis turbed by way of a hypertrophic structure of fibrotic tissue. For those severe sorts of liver disorder and for serious occasions prior to and after liver surgical procedure, man made liver help is required. This publication comprises the newest leads to this sector of study pre sented by way of scientists from allover the area at a world symposium held in Celle, Germany, June 2-4, 1980. interesting new equipment like non-stop membrane plasma sepa ration and liver cellphone transplantation into the spleen were de veloped. The older tools of hemoperfusion and dialysis were more suitable. Enzymological tools and liver transplantation have made solid growth. we are hoping that this quantity might help the clinician in his decision-making and stimulate creative new re look for the advantage of our liver patients.
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In Reye's syndrome fatty-acidemia is of major direct significance. In fulminant hepatic failure its role is probably indirect, perhaps operating through its synergism with ammonia and mercaptans. Synergisms Dose-Response Studies Methanethiol and ammonia come largely from the same source, the gut, and influence each other's toxicity (Zieve L et al. 1974). In Fig. 12% by volume inhaled) of methanethiol on the dose-response curve for NH4CI in normal rats. 45 mmol. In the presence of the subcoma dose of methanethiol the dose-response curve was shifted to the left and the CD50 was reduced by 68%.
80 .. 60 <3 40 E Fig. 2. 4 mmol) of octanoic acid (FA). O Dos~ of NH~lmmol~s) of insulin were more sensitive to the effects ofNH+ 4 or of octanoic acid. The COSO for NH+ 4 and for octanoate were each reduced by approximately 30%. 6 mmol octanoate caused coma. Warren and Schenker (1960) have likewise shown in mice that hypoxia has a similar augmenting effect on the toxicity of NW 4. Blood Studies Blood levels of NH 3 and plasma levels of octanoate at which coma occured in normal rats were markedly reduced when both substances were injected simultaneously.
S. s. 01 Hexanoate Hexanoate Hexanoate Phenol Phenol Phenol NH3 . 001 Phenol Hexsnoate Fig. 3. Molar coma doses in the rabbit for phenol, hexanoate and ammonium acetate alone and in combination that the widely accepted toxins, free fatty acids and ammonia. The effect of mercaptans in the rabbit are now under investigation and will be reported in due time. Since phenol belongs to the group of lipophilic compounds and is derived from the highly increased aromatic amino acids, tyrosine and phenylalanine, this fact must be taken into consideration for therapeutic approaches.
Artificial Liver Support by Hans Popper (auth.), Professor Dr. Gorig Brunner, Professor Dr. Friedrich Werner Schmidt (eds.)