Abstract
Aim: To investigate the efficacy of plasma exchange (PE) in the treatment of patients with acute on chronic or acute liver failure.
Methods: We retrospectively compared the treatment responses of PE and conservative care in patients with acute liver failure from 1998 to 2003. Thirty-two patients treated using supportive care only were enrolled as the control group. The sequential liver biochemical tests, consciousness levels, and survival rates were analyzed.
Results: There were no significant differences between the PE and control groups in terms of age, gender, underlying liver disease, grading of hepatic encephalopathy, levels of albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombin time (PT), activated partial thromboplastin time (aPTT), and total bilirubin. The number of days of survival for the PE group was significantly higher than that of the control group (17.63±1.86 days vs. 8.69±0.86 days, respectively; p<0.05). However, the survival rate was not meaningfully different between the groups (66.7% vs. 59.4%). Transient improvement of hyperbilirubinemia and encephalopathy grade was noted in the PE group compared with the control group.
Conclusions: The short-term outcome was better with PE, suggesting perhaps a temporary improvement which would only be of benefit whilst awaiting liver transplantation.