Abstract | OBJECTIVE: The artificial liver support system (ALSS) is used frequently as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). This study aims to compare the therapeutic efficacy of double plasma molecular adsorption system (DPMAS) with sequential half-dose plasma exchange (PE) (DPMAS+PE) and full-dose PE in patients with HBV-ACLF. METHODS: A total of 131 hospitalized patients who were diagnosed with HBV-ACLF and underwent DPMAS+PE or PE were retrospectively analyzed. According to the treatment methods used, they were divided into PE group (n = 77) and DPMAS+PE group (n = 54). The main evaluation indexes included the change of liver function and the 28-days liver transplant-free survival rates after the different treatments. RESULTS: There were no significant differences on severity of illness between PE group and DPMAS+PE group (P > 0.05). The total bilirubin (TBIL) levels immediately after treatment, and at 24 and 72 hours after treatment were markedly decreased in DPMAS+PE group than that in PE group (52.3 ± 9.4% vs 42.3 ± 7.2%, P < 0.05; 24.2 ± 10.0% vs 13.5 ± 13.0%, P < 0.05; 24.8 ± 13.1% vs 14.9 ± 14.9%, P < 0.05; respectively). The 28-days survival rates was 62.3% and 72.2% in PE and DPMAS+PE groups (P = 0.146). Furthermore, the 28-days survival rates were significantly higher in DPMAS+PE group than that in PE group (57.4% vs 41.7%, P = 0.043) in the intermediate-advanced stage patients. CONCLUSION: Compared with PE alone, DPMAS+PE might more effectively improve temporary TBIL in ACLF patients, and improve the 28-days survival rates in HBV-ACLF patients with intermediate-advanced stage. Therefore, DPMAS+PE may be an available ALSS treatment for HBV-ACLF patients.
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Authors | Jia Yao, Shuang Li, Li Zhou, Lei Luo, Lili Yuan, Zhongping Duan, Jun Xu, Yu Chen |
Journal | Journal of clinical apheresis
(J Clin Apher)
Vol. 34
Issue 4
Pg. 392-398
(Aug 2019)
ISSN: 1098-1101 [Electronic] United States |
PMID | 30758886
(Publication Type: Journal Article)
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Copyright | © 2019 The Authors. Journal of Clinical Apheresis published by Wiley Periodicals, Inc. |
Chemical References |
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Topics |
- Acute-On-Chronic Liver Failure
(mortality, therapy, virology)
- Adsorption
- Bilirubin
(analysis)
- Female
- Hepatitis B virus
- Humans
- Liver
(physiology)
- Liver Transplantation
- Male
- Middle Aged
- Plasma Exchange
(methods)
- Retrospective Studies
- Survival Rate
- Treatment Outcome
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