Assessment of the combined effect of plasma exchange and plasma perfusion on patients with severe hepatitis awaiting orthotopic liver transplantation.
To determine if plasma exchange combined with plasma perfusion is a reliable and effective temporary liver support treatment for patients on the waiting list for OLT, we tested this method in 5 patients with end-stage and 3 patients with middle-stage severe hepatitis. Four patients were successfully controlled until a donor liver was available 4 to 13 days later. In contrast, the remaining 4 patients were not adequately controlled by this treatment and experienced aggravated disease progression, dying 3 to 8 days after treatment while still awaiting OLT. Of those 4 patients who received OLT, 2 patients died from multi-organ failure caused by hepatic failure, while the other 2 survived. These findings show that plasma exchange combined with plasma perfusion provides temporary support for some patients on the waiting list for OLT. The ability of patients to successfully bridge to OLT is closely associated with the degree of liver failure, complications, multi-organ failure, and the length of the waiting period for a donor liver.
Institute of Infectious Diseases, Artificial Liver Unit, Southwest Hospital, Third Military Medical University, Chongqing, China. wangyj103@263.net
Y J
YJ
Wang
N H
NH
He
Z W
ZW
Wang
R Z
RZ
Niu
J
J
Liu
H W
HW
Wen
J J
JJ
Li
M D
MD
Li
Y M
YM
Wang
D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000628:therapy*; D006801:Humans; D017093:Liver Failure / Q000150:complications / Q000628:therapy* / Q000821:virology; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010951:Plasma Exchange; D016896:Treatment Outcome; D014850:Waiting Lists