Effects of artificial liver support system on patients with acute or chronic liver failure.
OBJECTIVE
Acute on chronic liver failure (AoCLF) is associated with a high mortality rate. Artificial liver support system (ALSS) is useful to bridge patients with liver failure to liver transplantation or to regenerate their own livers. The aims of this prospective study were to investigate the effects of ALSS on clinical manifestations, liver function, and 30-day survival to probe the factors related to mortality in patients with AoCLF.


METHODS
In this study, 338 enrolled patients with AoCLF who received ALSS treatment for 1 to 8 sessions, were compared with 312 patients treated with conventional medications.


RESULTS
Clinical manifestations and liver functions were significantly improved, namely, decreased levels of serum transaminases, total bilirubin, and bile acid, as well as increased levels of serum albumin following ALSS treatment. The 30-day survival rates of the patients who received ALSS versus controls were 47.9% versus 34.6%, respectively (P = .01). The MELD score and the stage of hepatic encephalopathy were highly associated with mortality (P < .001), but the sessions of ALSS showed a positive relation to the 30-day survival (P < .05).


CONCLUSIONS
ALSS appears to be efficacious and safe for the treatment of patients with AoCLF. Both model for end-stage liver disease (MELD) score and hepatic encephalopathy are useful to predict the mortality of patients.
Du
W B
WB
Key Laboratory of Infectious Diseases, Ministry of Public Health of China, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Li
L J
LJ
Huang
J R
JR
Yang
Q
Q
Liu
X L
XL
Li
J
J
Chen
Y M
YM
Cao
H C
HC
Xu
W
W
Fu
S Z
SZ
Chen
Y G
YG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006501:Hepatic Encephalopathy / Q000401:mortality / Q000628:therapy; D006801:Humans; D017093:Liver Failure / Q000401:mortality / Q000628:therapy*; D017114:Liver Failure, Acute / Q000628:therapy*; D008111:Liver Function Tests; D008115:Liver Regeneration; D016031:Liver Transplantation; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D001663:Bilirubin