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NKTI wins award for innovative multi-organ failure treatment

This is a press release

The National Kidney and Transplant Institute was recently awarded by Healthcare Asia with the SERVICE INOVATION OF THE YEAR AWARD for 2020 for its entry, “HEMOPERFUSION: an innovative adsorption technology for multi-organ failure.”

Healthcare Asia recognizes excellence in the Asia Pacific's healthcare sector, through the Healthcare Asia Awards 2020. This award honors hospitals and clinics that rise above challenges and recognizes initiatives that have made a tremendous positive impact to their patients and the healthcare industry. These best practices among Asia’s premium healthcare facilities serve as models of breakthrough practices in various fields of the healthcare sector.

Leptospirosis is the scourge of an urban city that has resulted in a devastating disease caused by floods and a rat-infested environment. This was the experience of the National Kidney and Transplant Institute (NKTI) in 2018 and 2019 with the upsurge of patients admitted with severe leptospirosis accompanied by kidney failure, liver dysfunction and lung hemorrhage.

NKTI is a tertiary renal referral center, thus majority of the leptospirosis patients admitted require dialysis for acute kidney injury. There are patients however with severe disease marked by sepsis and multi-organ failure. We now know that the organ failure resulting from severe leptospirosis is reversible, with recovery ranging from 2wks for the kidneys and up to 8 wks for the lungs.

The leptospires induce the release of inflammatory mediators that result in leaky blood vessels. The extravagant host immune response ultimately leads to organ damage resulting in acute kidney injury, liver failure and pulmonary hemorrhage requiring dialysis and mechanical ventilation.

Although conventional HD replaces kidney function while the kidney recovers, patients presenting with cardiovascular collapse are unable to tolerate dialysis, despite blood pressure support. HEMOPERFUSION, an extracorporeal blood purification modality successfully removes inflammatory mediators, through adsorption to a sorbent material. The removal of pro-inflammatory cytokines results in cardiovascular stability and cell responsiveness. Blood pressure stabilizes, dialysis can be effectively performed and lung injury improves. The use of HEMOPERFUSION using the sepsis cartridge was used in 20 patients with leptospirosis with acute kidney injury and pulmonary hemorrhage. This is the first report of 20 cases.

This advanced technology was performed in 20 leptospirosis patients with multi-organ failure requiring dialysis and ECMO therapy. All the patients were successfully dialyzed following HEMOPERFUSION. Inotropic support became unnecessary in all patients. The patients had an 80% survival and discharged with complete recovery of renal and lung function. Pulmonary hemorrhage usually results in 100% mortality, however, with ECMO and HEMOPERFUSION, only 3 patients died. Thus the combination of HEMOPERFUSION and ECMO resulted in an effective innovative treatment in leptospirosis with multi-organ failure.

HEMOPERFUSION is now considered part of the Institute’s protocol for multi-organ support for patients with severe sepsis due to leptospirosis, and because of this success, it can now be studied in other diseases with multi-organ failure. This new technology will have a huge impact in saving more lives in devastating diseases. –