Artificial Liver Support System: Complications and Prevention

Artificial liver support system, although considered a relatively safe procedure, might cause complications especially in liver disease patients with accompanied underlying coagulopathy, hypoalbuminemia, and impaired hemodynamic response leading to bleeding and hypotension as the most frequently seen complications clinically. As with all extracorporeal treatments requiring the use of external apparatus and vascular access entry, catheter-related blood clot formation, and infections may be observed that can be prevented with proper utilization of anticoagulants and prophylactic antibiotics, respectively. Rarely, air emboli and microthrombus leading to the subsequent fatal pulmonary embolism may also occur. In addition, the use of protein-containing replacement fluid may induce allergic reactions manifesting commonly as urticaria and pruritus. The most serious complications are seen when there is an anaphylactoid reaction to fresh frozen plasma. However, its rate of occurrence is very low at 0.12–1% as preexisting condition of the patients itself may have been the precipitating cause and low rate of mortality has been reported if prompt management is provided. Other rare clinical phenomena that may develop during artificial liver support system treatment processes include acute hemolysis, dialysis disequilibrium syndrome, and deletion syndrome.