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. 2017 Nov 6;7:14518. doi: 10.1038/s41598-017-15021-4

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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(a–g) Comparison of parameters of severity of acute liver failure in control empty bead BAL (-o-) treated pig vs. Cell-BAL treated pig (•), with similar degrees of liver dysfunction prior to connection to the BAL. BAL treatment started at 2.5 h. Both pigs had same ammonia levels at connection to the BAL. Control-treated pig survived 6 h after liver failure induction, Cell-treated pig survived >12 h after liver failure induction. Vertical dashed line signifies time at which BAL was added. (a) pH (b) Lactate. (c) Base and bicarbonate. (d) Anion gap. (e) Prothrombin time and INR. (f) ICP change from baseline. Control-BAL (○) exhibited a rapid rise in ICP compared with Cell-BAL (●), i.e. Control-BAL 154% change from baseline per hour; Cell-BAL 25% change from baseline per hour. (g) Vasopressor requirements: noradrenaline was administered IV at rates required targeting a cerebral perfusion pressure (CPP) of 60 mmHg, so the blood pressure was optimised depending on the ICP.