Double plasma molecular adsorption system and sequential half-dose plasma exchange improves short-term prognosis of patients with hepatitis B associated acute-on-chronic liver failure

Chenggao WU; Wei Liu; Linju Kuang; Qiang Liu; Wei Xiong; Piaoping HU; Changlin Zhang; Aiping LE

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Double plasma molecular adsorption system and sequential half-dose plasma exchange improves short-term prognosis of patients with hepatitis B associated acute-on-chronic liver failure

VernacularTitle:双重血浆分子吸附系统序贯半量血浆置换改善乙肝相关慢加急性肝衰竭患者的短期预后
Author: Chenggao WU ¹ ; Wei LIU ¹ ; Linju KUANG ¹ ; Qiang LIU ² ; Wei XIONG ² ; Piaoping HU ¹ ; Changlin ZHANG ¹ ; Aiping LE ^{1
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Author Information

1. Transfusion Medicine Department, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
2. Key Laboratory of Jiangxi Province for Transfusion Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
3. Key Laboratory of Jiangxi Province for Transfusion Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
Publication Type:Journal Article
Keywords: Hepatitis B associated acute-on-chronic liver failure(HBV-ACLF); double plasma molecular adsorption system(DPMAS); plasma exchange; prognostic outcome
From: Chinese Journal of Blood Transfusion 2024;37(1):9-15
CountryChina
Language:Chinese
Abstract: 【Objective】 To investigate the effect of double plasma molecular adsorption system and sequential half-dose plasma exchange (DPMAS+HPE) on the short-term survival rate of patients with hepatitis B associated acute-on-chronic liver failure (HBV-ACLF). 【Methods】 Data on HBV-ACLF cases hospitalized in our hospital from January 1, 2015 to December 31, 2022 were retrospectively collected, and were divided into standard comprehensive medical treatment group and DPMAS+HPE group according to different treatment methods. Propensity score matching (PSM) was used to eliminate inter group confounding bias. The baseline data and improvement of laboratory indicators after treatment between two groups were compared. Death related risk factors in HBV-ACLF patients were screened by logistic regression analysis, and cumulative survival rates at 30 and 90 days between the two groups were compared by Kaplan-Meier survival analysis. 【Results】 A total of 373 cases of HBV-ACLF were included in this study. Among them, 136 cases in the treatment group received DPMAS+HPE once on the basis of comprehensive internal medicine treatment, and 237 cases only received comprehensive internal medicine treatment. After PSM, 136 patients were included as the control group. The decrease in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total protein (TP) in the treatment group before and after treatment was significantly greater than that in the control group (446.5 vs 159.0, 317.0 vs 92.0,5.2 vs 0.3), with statistically significant difference (P<0.05). DPMAS+HPE treatment is an independent protective factor for mortality in HBV-ACLF patients at 30 and 90 days (30 days: OR=0.497, P<0.05; 90 days: OR= 0.436, P<0.05). The cumulative survival rates at 30 and 90 days in the treatment group were significantly higher than those in the control group (30 days: 50.71% vs 44.12%, P<0.05; 90 days: 30.15% vs 22.79%, P<0.05). 【Conclusion】 DPMAS+HPE improves the short-term prognosis of HBV-ACLF patients and can serve as an effective artificial liver model for the treatment of HBV-ACLF patients.