Abstract：
Multiple organ failure (MOF) is a common and deadly condition. Patients with liver cirrhosis with acute-on-chronic liver failure (AOCLF) are particularly susceptible. Excess fluid accumulation in tissues makes routine hemodialysis generally ineffective because of cardiovascular instability. Patients with three or more organ failures face a mortality rate of more than 90%. Many cannot survive liver transplantation. Extracorporeal support systems like MARS (Baxter, Deerfield, IL) and Prometheus (Bad Homburg, Germany) have shown promise but fall short in bridging patients to transplantation. A novel Artificial Multi-organ Replacement System (AMOR) was developed at the University of Washington Medical Center. AMOR removes protein-bound toxins through a combination of albumin dialysis, a charcoal sorbent column, and a novel rinsing method to prevent sorbent column saturation. It removes excess fluid through hemodialysis. Ten AOCLF patients with over three organ failures were treated by the AMOR system. All patients showed significant clinical improvement. Fifty percent of the cohort received liver transplants or recovered liver function. AMOR was successful in removing large amounts of excess body fluid, which regular hemodialysis could not. AMOR is cost-effective and user-friendly. It removes excess fluid, supporting the other vital organs such as liver, kidneys, lungs, and heart. This pilot study\'s results encourage further exploration of AMOR for treating MOF patients.
摘要：
多器官衰竭（MOF）是一种常见且致命的疾病。患有慢性急性肝衰竭（AOCLF）的肝硬化患者特别易感。由于心血管不稳定，组织中多余的液体积聚使常规血液透析通常无效。患有三个或更多器官衰竭的患者面临超过90%的死亡率。许多人无法在肝移植中存活。体外支持系统，如MARS(巴克斯特，迪尔菲尔德,IL）和普罗米修斯（BadHomburg，德国）已显示出希望，但在将患者与移植桥接方面却不足。华盛顿大学医学中心开发了一种新型的人工多器官置换系统（AMOR）。AMOR通过白蛋白透析的组合去除蛋白质结合的毒素，木炭吸附剂柱，和一种防止吸附剂柱饱和的新型冲洗方法。它通过血液透析去除多余的液体。通过AMOR系统治疗了10名超过3个器官衰竭的AOCLF患者。所有患者均表现出显著的临床改善。50％的队列接受了肝移植或恢复肝功能。AMOR成功清除了大量多余的体液，常规血液透析不能。AMOR具有成本效益和用户友好性。它去除多余的液体，支持其他重要器官，如肝脏，肾脏，肺,和心脏。这项初步研究的结果鼓励进一步探索AMOR治疗MOF患者。
