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Monday December 4, 2000

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UMC first in country to use liver dialysis machine to treat trauma patient

By Emily Severson

Arizona Daily Wildcat

Machine clears toxins to help liver regenerate

A man who was shot in the liver is on a liver dialysis machine at the University Medical Center to treat his trauma wound for the first time in U.S. medical history.

On Friday, a Tucson man received the last of three treatments that doctors hope will help regenerate his liver at the UMC. The man was hooked up to the machine three times for four to six hour sessions, said Joyce Rudders, a clinical manager at Hemotherapies and registered nurse, a company that works with dialysis machines in Phoenix.

This is also the first time the machine has been used in Southern Arizona to assist the function of the liver.

The man is still in critical condition but is getting better, Johnson said.

"We are going to hold off from doing any more dialysis because there is not a reason for it now," he said.

The wound destroyed about 70 percent of his liver. To regenerate the liver, the machine was used to clear toxins in the organ, similar to cleaning a wound, said Dr. Steven Johnson, an associate professor of surgery in the trauma section and chief of surgical critical care at the University of Arizona College of Medicine.

Physicians at UMC decided to use the machine because it could help relieve the stress on the patient's injured liver and enable the liver to regenerate.

Without the machine, the only other option for the man was to hope the liver regenerates on its own, Johnson said.

"The dialysis machine takes the workload off the liver," Rudders said. "Hopefully, this will facilitate the toxic ammonia levels decreasing in stages."

Recently approved by the Food and Drug Administration, the liver dialysis machine is the only liver-assist technology available today.

Johnson said that the unit could be used to treat up to 100 patients a year at UMC. Those who would most likely receive treatment would either be people with chronic liver problems or who have overdosed on drugs.

The machine functions by using charcoal to remove toxins from the bloodstream without coming into direct contact with the blood. It cost UMC $80,000 and each treatment costs $4,000.

No nurses at UMC are trained in monitoring the machine and it has not been determined if they will offer training to operate the machine, Rudders said.