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Efficacy of continuous plasma diafiltration therapy in critical patients with acute liver failure
Author(s) -
Komura Takuya,
Taniguchi Takumi,
Sakai Yoshio,
Yamashita Tatsuya,
Mizukoshi Eishiro,
Noda Toru,
Okajima Masaki,
Kaneko Shuichi
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12440
Subject(s) - medicine , diafiltration , liver failure , intensive care medicine , membrane , genetics , biology , microfiltration
Abstract Background and Aims Acute liver failure ( ALF ) is a critical illness with high mortality. Plasma diafiltration ( PDF ) is a blood purification therapy that is useful for ALF patients, but it is difficult to use when those patients have multiple organ failure or unstable hemodynamics. In these patients, symptoms are also likely to exacerbate immediately after PDF therapy. We developed continuous PDF ( CPDF ) as a new concept in PDF therapy, and assessed its efficacy and safety in ALF patients. Methods Ten ALF patients (gender: M/ F 6/4, Age: 47 ± 14) were employed CPDF therapy. The primary outcomes were altered liver function, measured by the model for end‐stage liver disease ( MELD ) score, and total bilirubin and prothrombin time international normalized ratios ( PT‐INR ), 5 days after CPDF therapy. Secondary outcomes included sequential organ failure assessment ( SOFA ) scores, 5 days after CPDF therapy, and the survival rate 14 days after this therapy. Results The MELD score (34.5–28.0; P = 0.005), total bilirubin (10.9–7.25 mg/dL; P = 0.048), PT ‐ INR (1.89–1.31; P = 0.084), and SOFA score (10.0–7.5; P < 0.039) were improved 5 days after CPDF therapy. Nine patients were alive, and one patient died because of acute pancreatitis, complicated by ALF . There were no major adverse events related to this therapy under hemodynamic stability. Conclusion I n the present study, CPDF therapy safely supported liver function and generally improved the condition of critically ill patients with ALF .