Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure.
BACKGROUND:The search for a strategy to provide temporary liver support and salvage the patients with acute-on-chronic liver failure (ACLF) remains an important issue. This study was designed to evaluate the experience in artificial liver support system (ALSS) combined with liver transplantation (LT...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3597613?pdf=render |
| _version_ | 1818194914570141696 |
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| author | Xiao Xu Xiaoli Liu Qi Ling Qiang Wei Zhikun Liu Xiaowei Xu Lin Zhou Min Zhang Jian Wu Jianrong Huang Jifang Sheng Shusen Zheng Lanjuan Li |
| author_facet | Xiao Xu Xiaoli Liu Qi Ling Qiang Wei Zhikun Liu Xiaowei Xu Lin Zhou Min Zhang Jian Wu Jianrong Huang Jifang Sheng Shusen Zheng Lanjuan Li |
| author_sort | Xiao Xu |
| collection | DOAJ |
| description | BACKGROUND:The search for a strategy to provide temporary liver support and salvage the patients with acute-on-chronic liver failure (ACLF) remains an important issue. This study was designed to evaluate the experience in artificial liver support system (ALSS) combined with liver transplantation (LT) in the treatment of ACLF. METHODOLOGY/PRINCIPAL FINDINGS:One hundred and seventy one patients with HBV related ACLF undergoing LT between January 2001 and December 2009 were included. Of the 171 patients, 115 received 247 sessions of plasma exchange-centered ALSS treatment prior to LT (ALSS-LT group) and the other 56 received emergency LT (LT group). The MELD score were 31±6 and 30±7 in ALSS-LT group and LT group. ALSS treatment resulted in improvement of liver function and better tolerance to LT. The average level of serum total bilirubin before LT was lower than that before the first time of ALSS treatment. The median waiting time for a donor liver was 12 days (2-226 days) from the first run of ALSS treatment to LT. Compared to LT group, the beneficial influences of ALSS on intraoperative blood loss and endotracheal intubation time were also observed in ALSS-LT group. The 1-year and 5-year survival rates in the ALSS-LT group and LT group were 79.2% and 83%, 69.7% and 78.6%. CONCLUSIONS/SIGNIFICANCE:Plasma exchange-centered ALSS is beneficial in salvaging patients with ACLF when a donor liver is not available. The consequential LT is the fundamental treatment modality to rescue these patients and lead to a similar survival rate as those patients receiving emergency transplantation. |
| first_indexed | 2024-12-12T01:09:52Z |
| format | Article |
| id | doaj.art-21db88a2c3fa45d981364f04e5d631a7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T01:09:52Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-21db88a2c3fa45d981364f04e5d631a72022-12-22T00:43:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0183e5873810.1371/journal.pone.0058738Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure.Xiao XuXiaoli LiuQi LingQiang WeiZhikun LiuXiaowei XuLin ZhouMin ZhangJian WuJianrong HuangJifang ShengShusen ZhengLanjuan LiBACKGROUND:The search for a strategy to provide temporary liver support and salvage the patients with acute-on-chronic liver failure (ACLF) remains an important issue. This study was designed to evaluate the experience in artificial liver support system (ALSS) combined with liver transplantation (LT) in the treatment of ACLF. METHODOLOGY/PRINCIPAL FINDINGS:One hundred and seventy one patients with HBV related ACLF undergoing LT between January 2001 and December 2009 were included. Of the 171 patients, 115 received 247 sessions of plasma exchange-centered ALSS treatment prior to LT (ALSS-LT group) and the other 56 received emergency LT (LT group). The MELD score were 31±6 and 30±7 in ALSS-LT group and LT group. ALSS treatment resulted in improvement of liver function and better tolerance to LT. The average level of serum total bilirubin before LT was lower than that before the first time of ALSS treatment. The median waiting time for a donor liver was 12 days (2-226 days) from the first run of ALSS treatment to LT. Compared to LT group, the beneficial influences of ALSS on intraoperative blood loss and endotracheal intubation time were also observed in ALSS-LT group. The 1-year and 5-year survival rates in the ALSS-LT group and LT group were 79.2% and 83%, 69.7% and 78.6%. CONCLUSIONS/SIGNIFICANCE:Plasma exchange-centered ALSS is beneficial in salvaging patients with ACLF when a donor liver is not available. The consequential LT is the fundamental treatment modality to rescue these patients and lead to a similar survival rate as those patients receiving emergency transplantation.http://europepmc.org/articles/PMC3597613?pdf=render |
| spellingShingle | Xiao Xu Xiaoli Liu Qi Ling Qiang Wei Zhikun Liu Xiaowei Xu Lin Zhou Min Zhang Jian Wu Jianrong Huang Jifang Sheng Shusen Zheng Lanjuan Li Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. PLoS ONE |
| title | Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. |
| title_full | Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. |
| title_fullStr | Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. |
| title_full_unstemmed | Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. |
| title_short | Artificial liver support system combined with liver transplantation in the treatment of patients with acute-on-chronic liver failure. |
| title_sort | artificial liver support system combined with liver transplantation in the treatment of patients with acute on chronic liver failure |
| url | http://europepmc.org/articles/PMC3597613?pdf=render |
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