Browse by author
Lookup NU author(s): Professor David Jones
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Background Intractable pruritus is a major problem for some patients with cholestasis. Albumin dialysis has been shown to ameliorate pruritus, but long-term outcome data are limited. Aim To evaluate the safety and efficacy of 'out-patient' albumin dialysis using the molecular adsorbent recirculating system (MARS) in the treatment of intractable pruritus in cholestatic patients referred for liver transplantation for symptomatic relief. Methods Fifteen patients who failed to respond to standard medical therapy to control pruritus were included. Three MARS (6 h) sessions were performed per admission, and were repeated, if necessary. The intensity and severity of itch was quantified using itch severity and visual analogue scales (ISS and VAS). Results Molecular adsorbent recirculating system treatment was safe and associated with immediate and complete response in 11 patients; two patients had a partial response and two patients had no response. Thirty-four treatments were performed during a follow-up period of 15.7 months (3-46) with patients requiring a mean of two admissions (1-6). The mean VAS and ISS improved significantly (both P < 0.001) with improvement in the patient's perception of their quality of life. The duration of acceptable relief in responders was 3.3 months (range 2-5). No serious adverse events were recorded, but the platelet count and haemoglobin were reduced significantly. Conclusion Molecular adsorbent recirculating system therapy delivered in an 'outpatient' setting is safe and effective with a high degree of patient acceptability. Albumin dialysis can be considered a viable therapeutic option for patients with severe intractable pruritus, in whom, the only other effective treatment option is liver transplantation.
Author(s): Leckie P, Tritto G, Mookerjee R, Davies N, Jones D, Jalan R
Publication type: Article
Publication status: Published
Journal: Alimentary Pharmacology and Therapeutics
Print publication date: 20/01/2012
ISSN (print): 0269-2813
ISSN (electronic): 1365-2036
Publisher: Wiley-Blackwell Publishing Ltd.
Altmetrics provided by Altmetric