Abstract #1496

Zwingmann C, Ytrebo L, Butterworth R, Revhaug A, Jalan R, Leibfritz D, Sen S, Rose C, Davies N

Encephalopathy in acute liver failure (ALF) is characterised by increased brain water in grey and white matter (GM and WM). Our aim was to perform ex vivo 1H-NMR to explore previous observations that albumin dialysis (MARS) reduces cerebral swelling only in the WM. In ALF, brain water increases in GM and WM. However only 6/11 metabolite changes are similar. The MARS-induced normalisation of brain water in the WM was paralleled by a normalization of 7/11 metabolites. Since MARS only normalised WM tissue water, this suggests that increases in brain water in WM vs GM are associated with different pathophysiological mechanisms.