Efficacy and complications of plasma exchange combined with dual plasma molecular adsorption system in elderly patients with acute liver failure
Zhu Zhengyun
Zhang Tingting
Liu Danfeng
Yang Liuqing
Li Jingjing
Abstract：Objective To investigate the efficacy and complications of plasma exchange(PE)combined with dual plasma molecular adsorption system(DPMAS)in elderly patients with acute liver failure.Methods A total of 52 elderly patients with acute liver failure treated with PE+DPMAS in our hospital were enrolled from June 2020 to May 2023.They were randomly divided into groups A and B.In group A patients were treated with DPMAS before PE.In group B patients were treated with PE before DPMAS.The condition improvement,complications and machine parameter alarms of the two groups were evaluated and compared.Results In both groups the levels of total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),plasma albumin(ALB),prothrombin time(PT)and prothrombin activity(PTA)were significantly improved(P<0.05).The difference of ALB before and after treatment in group A was(-2.94±1.81)g/L and was(-2.35±1.88)g/L in group B,and the difference of PTA before and after treatment was(-11.45±7.83)%in group A and was(-9.15±6.33)%in group B.The differences of ALB and PTA before and after treatment were significant different between the two groups(t=-2.00,P=0.047 and t=-2.03,P=0.044,respectively).Compared with group B,group A was more prone to hypotension(18.75%vs.6.41%,χ2=4.236,P=0.040).The incidence of allergic reaction in group B was higher than that in group A(11.54%vs.2.50%,χ2=4.336,P=0.037).Group B was more prone to PV alarm(16.67%vs.5.00%,χ2=4.571,P=0.034)and membrane rupture alarm(7.69%vs.1.25%,χ2=3.933,P=0.047),while the PA alarm rate of group A was higher(21.25%vs.7.69%,χ2=4.375,P=0.036).Conclusion PE+DPMAS with different successive sequences can significantly improve the condition of elderly patients with acute liver failure,and the improvement effects of TBIL and PTA in patients with DPMAS before PE are superior to those with PE before DPMAS.For the occurrence of complications and abnormal machine alarms during PE+DPMAS treatment with different successive sequences,prevention and treatment can be done in advance to ensure the treatment effect.
Keywords：Liver failurePlasma exchangeComplications
Publication Date：2025-01-20
Online Publishing Date：2025-10-31(First online date of this platform, not the publication date of the document)
Pages：6( 55-60 )