|
|
|
| Plasma exchange-centered artificial liver support system in hepatitis B virus-related acute-on-chronic liver failure: a nationwide prospective multicenter study in China |
| Jia-Jia Chen, Jian-Rong Huang, Qian Yang, Xiao-Wei Xu, Xiao-Li Liu, Shao-Rui Hao, Hui-Fen Wang, Tao Han, Jing Zhang, Jian-He Gan, Zhi-Liang Gao, Yu-Ming Wang, Shu-Mei Lin, Qing Xie, Chen Pan and Lan-Juan Li |
Hangzhou, China
Author Affiliations: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China (Chen JJ, Huang JR, Yang Q, Xu XW, Liu XL, Hao SR and Li LJ); Liver Failure Therapy and Research Center, 302 Hospital of People’s Liberation Army, Beijing 100039, China (Wang HF); Department of Hepatology, Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China (Han T); Artificial Liver Center, You’an Hospital, Capital Medical University, Beijing 100069, China (Zhang J); Department of Infectious Diseases, First Affiliated Hospital of Suzhou University, Suzhou 215006, China (Gan JH); Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China (Gao ZL); Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China (Wang YM); Department of Infectious Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China (Lin SM); Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China (Xie Q); Department of Infectious Diseases, Infectious Diseases Hospital Affiliated to Fujian Medical University, Fuzhou 350025, China (Pan C)
Corresponding Author: Lan-Juan Li, MD, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, and Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China (Tel/Fax: +86-571-87236755; Email: ljli@zju.edu.cn) |
|
|
|
|
Abstract BACKGROUND: Plasma exchange (PE)-centered artificial liver support system reduced the high mortality rate of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). But the data were diverse in different medical centers. The present prospective nationwide study was to evaluate the effects of PE on patients with HBV-ACLF at different stages.
METHODS: From December 2009 to December 2011, we evaluated 250 patients at different stages of HBV-ACLF from 10 major medical centers in China. All the laboratory parameters were collected at admission, before and after PE.
RESULTS: Among the 250 patients who underwent 661 rounds of PE, one-month survival rate was 61.6%; 141 (56.4%) showed improvement after PE. Variables such as age (P=0.000), levels of total bilirubin (TB, P=0.000), direct bilirubin (P=0.000), total triglycerides (P=0.000), low-density lipoprotein (P=0.022), Na+ (P=0.014), Cl– (P=0.038), creatinine (Cr, P=0.007), fibrinogen (P=0.000), prothrombin time (PT, P=0.000), white blood cell (P=0.000), platelet (P=0.003) and MELD (P=0.000) were significantly related to prognosis. Multivariate logistic regression analysis showed that age, disease stage, TB, Cr and PT levels were independent risk factors of mortality among HBV-ACLF patients.
CONCLUSIONS: PE can improve the clinical outcome of patients with HBV-ACLF. Levels of TB, Cr and PT, age and disease stage help to predict prognosis.
|
|
|
|
|
|
|
|
|
2016, Vol. 15 
