{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T03:53:22Z","timestamp":1752983602814},"reference-count":50,"publisher":"Akademiai Kiado Zrt.","issue":"51","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,12,1]]},"abstract":"<jats:p>A m\u00e1jel\u00e9gtelens\u00e9g \u2013 ak\u00e1r kor\u00e1bbi m\u00e1jbetegs\u00e9g fenn\u00e1ll\u00e1sa n\u00e9lk\u00fcl alakult ki (akut m\u00e1jel\u00e9gtelens\u00e9g), ak\u00e1r kr\u00f3nikus m\u00e1jbetegs\u00e9g akut dekompenz\u00e1ci\u00f3ja (\u201eakut a kr\u00f3nikuson\u201d m\u00e1jel\u00e9gtelens\u00e9g) k\u00f6vetkezm\u00e9nye \u2013 magas hal\u00e1loz\u00e1ssal j\u00e1r. A v\u00e9g\u00e1llapot\u00fa m\u00e1jbetegs\u00e9gek k\u00f6vetkezt\u00e9ben kialakult m\u00e1jel\u00e9gtelens\u00e9g egyetlen kurat\u00edv megold\u00e1sa ma a m\u00e1jtranszplant\u00e1ci\u00f3. Ennek f\u0151 g\u00e1tj\u00e1t a rendelkez\u00e9sre \u00e1ll\u00f3 donorszervek hi\u00e1nya k\u00e9pezi, emiatt sok, v\u00e1r\u00f3list\u00e1n szerepl\u0151 beteg exit\u00e1l. A transzplant\u00e1ci\u00f3 korl\u00e1tai tett\u00e9k sz\u00fcks\u00e9gess\u00e9 olyan m\u00e1jt\u00e1mogat\u00f3 rendszerek kifejleszt\u00e9s\u00e9t, amelyek alkalmasak a beteg \u00e9letben tart\u00e1s\u00e1ra a szerv\u00e1t\u00fcltet\u00e9sig vagy a m\u00e1j regener\u00e1ci\u00f3j\u00e1ig. A korai pr\u00f3b\u00e1lkoz\u00e1sok (hemodial\u00edzis, hemoperf\u00fazi\u00f3, cseretranszf\u00fazi\u00f3, kereszthemodial\u00edzis, keresztkering\u00e9s, plazmafer\u00e9zis stb.) el\u00e9gtelennek bizonyultak. Napjainkban a m\u00e1jp\u00f3tl\u00f3 kezel\u00e9snek k\u00e9t f\u0151 ir\u00e1nya alakult ki: a sejtalap\u00fa, \u00fagynevezett bioartefici\u00e1lis \u00e9s a nem sejtalap\u00fa, \u00fagynevezett artefici\u00e1lis rendszerek. A bioartefici\u00e1lis rendszerek \u00e9l\u0151 \u00e1llati m\u00e1jsejteket vagy emberi m\u00e1jtumorsejteket tartalmaznak. Jellegzetess\u00e9g\u00fck, hogy a beteg v\u00e9r\u00e9t vagy szepar\u00e1lt plazm\u00e1j\u00e1t a m\u00e1jsejteket tartalmaz\u00f3 bioreaktoron \u00e1ramoltatj\u00e1k \u00e1t. Elviekben a m\u00e1jm\u0171k\u00f6d\u00e9st ezek a metodik\u00e1k modellezik a legt\u00f6k\u00e9letesebben, mert a m\u00e1j szintetiz\u00e1l\u00f3- \u00e9s detoxik\u00e1l\u00f3funkci\u00f3j\u00e1t egyar\u00e1nt p\u00f3tolj\u00e1k. Jelenlegi form\u00e1jukban azonban m\u00e9g t\u00e1vol \u00e1llnak az ide\u00e1lis megold\u00e1st\u00f3l, alkalmaz\u00e1suk sz\u00e1mos immunol\u00f3giai, infektol\u00f3giai, onkol\u00f3giai \u00e9s financi\u00e1lis probl\u00e9m\u00e1t vet fel, ez\u00e9rt egyel\u0151re csak k\u00eds\u00e9rleti c\u00e9lra \u00e1llnak rendelkez\u00e9sre. Az artefici\u00e1lis rendszerek a klinikum sz\u00e1m\u00e1ra m\u00e1r el\u00e9rhet\u0151ek, b\u00e1r sz\u00e9les k\u00f6rben m\u00e9g nem terjedtek el. Csak a m\u00e1j detoxik\u00e1l\u00f3funkci\u00f3j\u00e1t p\u00f3tolj\u00e1k, a szintetikus funkci\u00f3 r\u00e9szben a hi\u00e1nyz\u00f3 anyagok (plazmaproteinek, alvad\u00e1si faktorok) szubsztit\u00faci\u00f3j\u00e1val p\u00f3tolhat\u00f3. Idetartozik a hemodiabszorpci\u00f3, amely az Amerikai Egyes\u00fclt \u00c1llamokban terjedt el (liver dialysis unit), valamint a f\u0151leg Eur\u00f3p\u00e1ban haszn\u00e1latos albumindial\u00edzis \u00e9s a leg\u00fajabban kifejlesztett frakcion\u00e1lt plazmaszepar\u00e1ci\u00f3 \u00e9s -adszorpci\u00f3 (FPSA). Az albumindial\u00edzis egyszer\u0171 m\u00f3dszere a \u201esingle pass albumin dialysis\u201d (SPAD), ennek tov\u00e1bbfejlesztett v\u00e1ltozata a \u201emolecular adsorbent recirculating system\u201d (MARS). Az FPSA high-flux hemodial\u00edzissel kieg\u00e9sz\u00edtett v\u00e1ltozata a Prometheus-rendszer. B\u00e1r a felsorolt m\u00f3dszerek hat\u00e1soss\u00e1g\u00e1t sz\u00e1mos k\u00eds\u00e9rleti \u00e9s klinikai tanulm\u00e1ny t\u00e1masztja al\u00e1, a konzervat\u00edv kezel\u00e9ssel szemben a t\u00fal\u00e9l\u00e9sre kifejtett el\u0151ny\u00f6s hat\u00e1suk bizony\u00edt\u00e1s\u00e1ra m\u00e9g nagy esetsz\u00e1mot fel\u00f6lel\u0151, randomiz\u00e1lt, kontroll\u00e1lt vizsg\u00e1latok elv\u00e9gz\u00e9s\u00e9re van sz\u00fcks\u00e9g.<\/jats:p>","DOI":"10.1556\/oh.2009.28769","type":"journal-article","created":{"date-parts":[[2009,12,9]],"date-time":"2009-12-09T04:22:32Z","timestamp":1260332552000},"page":"2299-2307","source":"Crossref","is-referenced-by-count":7,"title":["Liver support systems today"],"prefix":"10.1556","volume":"150","author":[{"given":"Csaba","family":"Rikker","sequence":"first","affiliation":[{"name":"1 P\u00e9terfy S\u00e1ndor Utcai K\u00f3rh\u00e1z-Rendel\u0151int\u00e9zet \u00e9s Baleseti K\u00f6zpont Fresenius Medical Care Dial\u00edzisk\u00f6zpont Budapest P\u00e9terfy S\u00e1ndor u. 8\u201320. 1076"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","first-page":"398","volume":"2","year":"2005","journal-title":"Nat. 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