[Survival analysis on liver failure patients treated with an artificial liver support system].
OBJECTIVE
To evaluate the efficacy of artificial liver support system (ALSS) in the treatment of liver failure patients.


METHODS
This is a prospective, multi-center, controlled, large sample clinic trial. 518 patients with liver failure from 5 hospitals were studied and followed. All the patients received similar pharmacological manipulation according to one and the same protocol but were divided into an ALSS treatment group and a control group without ALSS treatment. The ALSS treatment procedures included plasma exchange, molecular adsorbent recirculating system (MARS), plasma exchange plus hemofiltration and other combined nonbioartificial methods. The analysis of survival time was computed using the Kaplain-Maier method, and comparison among groups was done using Log-Rank, Breslow and/or the Tarone-Ware test.


RESULTS
Survival time of acute liver failure patients was prolonged from 4.0+/-0.2 days to 8.0+/-0.4 days (P=0.004). ALSS was shown to be two times more effective. ALSS increased the survival time of acute on chronic (A on C) liver failure patients from 27.0+/-1.6 days to 39.0+/-4.0 days (P less than 0.01). In addition, it increased the survival time of the patients in the middle and end stage of subacute liver failure and A on C liver failure, but had no significant effects on early stage patients. The survival time of middle stage patients was 38.0+/-17.5 days in the control group vs 66.0+/-18.6 days in the ALSS group (P less than 0.05). The survival time of end stage patients of the control group and the ALSS group was 18.0+/-4.0 days vs 26.0+/-2.5 days (P less than 0.01).


CONCLUSIONS
Multi ALSS treatment is more effective than the standard medicinal liver care treatment. Multi-ALSS treatment could increase survival time of patients suffering from acute liver failure or A on C liver failure, especially in their middle and end stages. It is important and necessary to treat these patients with ALSS.
Zhang
Jing
J
Artificial Liver Center, Beijing You'an Hospital, Affiliated to Capital University of Medical Sciences, Beijing 100069, China.
Duan
Zhong-ping
ZP
He
Jin-qiu
JQ
Zhang
Lun-li
LL
Chen
Shi-bing
SB
Zou
Chun-yi
CY
Xin
Shao-jie
SJ
Wu
Wen-fang
WF
Ma
Bin-rong
BR
Chen
Yu
Y
Kong
Ming
M
Liu
Mei
M
Han
Da-kang
DK
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000401:mortality* / Q000628:therapy*; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D055815:Young Adult