1. Volume 39, Issue 6, Pages 984-990 (December 2003)
Prometheus® – a new extracorporeal system for the treatment of liver failure☆ 
Kinan Rifai, Thomas Ernst, Ulrich Kretschmer, Matthias J Bahr, Andrea Schneider, Carsten Hafer, Hermann Haller, Michael P Manns, Danilo Fliser 
Journal of Hepatology 
Volume 39, Issue 6, Pages (December 2003)
DOI: /S (03)

2. Fig. 1
Blood from the patient is pumped through a dialysis catheter and passes through an albumin-permeable polysulfon filter (AlbuFlow®). Molecules up to the size of albumin easily pass from the blood side into the secondary circuit. There the filtered albumin-rich plasma flows through one or two adsorbers in a row (prometh 01® and prometh 02®) where toxins are directly adsorbed (FPSA=‘fractionated plasma separation and adsorption’). The purified plasma then returns to the blood side of the albumin filter. Filtration and adsorption capacities are enhanced by using a plasma pump that recirculates the albumin-rich plasma. In order to eliminate water-soluble toxins, blood thereafter undergoes hemodialysis using a conventional high flux dialyser (FX 50).
Journal of Hepatology  , DOI: ( /S (03) )

3. Fig. 2
Maintenance and monitoring of the extracorporeal circuit is performed by a modified 4008 H hemodialysis unit. The extracorporeal blood circuit and the secondary fractionated plasma circuit are separately monitored by different hardware and software in the Prometheus® modular system. Thus, either conventional hemodialysis or simultaneous hemodialysis and plasma detoxification can be performed.
Journal of Hepatology  , DOI: ( /S (03) )

4. Fig. 3
Total, conjugated and unconjugated bilirubin serum concentrations before and after both treatment sessions with Prometheus® as well as 1 and 3 days after treatment (observation period). Data are given as median, quartiles and minimum/maximum values. Total bilirubin levels improved during Prometheus® therapy (P=0.06); conjugated bilirubin significantly decreased (P<0.02), whereas unconjugated bilirubin serum concentration increased (P<0.02).
Journal of Hepatology  , DOI: ( /S (03) )