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Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience

For patients with acute-on-chronic liver failure (ACLF), artificial liver support system (ALSS) may help prolong lifespan and function as a bridge to liver transplantation (LT), but data on its long-term benefit are lacking. We conducted this prospective, controlled study to determine the efficacy o...

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Autores principales: Qin, Gang, Shao, Jian-Guo, Wang, Bin, Shen, Yi, Zheng, Jian, Liu, Xian-Jin, Zhang, You-Yi, Liu, Yan-Mei, Qin, Yan, Wang, Lu-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603116/
https://www.ncbi.nlm.nih.gov/pubmed/25526495
http://dx.doi.org/10.1097/MD.0000000000000338
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author Qin, Gang
Shao, Jian-Guo
Wang, Bin
Shen, Yi
Zheng, Jian
Liu, Xian-Jin
Zhang, You-Yi
Liu, Yan-Mei
Qin, Yan
Wang, Lu-Jun
author_facet Qin, Gang
Shao, Jian-Guo
Wang, Bin
Shen, Yi
Zheng, Jian
Liu, Xian-Jin
Zhang, You-Yi
Liu, Yan-Mei
Qin, Yan
Wang, Lu-Jun
author_sort Qin, Gang
collection PubMed
description For patients with acute-on-chronic liver failure (ACLF), artificial liver support system (ALSS) may help prolong lifespan and function as a bridge to liver transplantation (LT), but data on its long-term benefit are lacking. We conducted this prospective, controlled study to determine the efficacy of ALSS and the predictors of mortality in patients with hepatitis B virus (HBV)-associated ACLF. From January 2003 to December 2007, a total of 234 patients with HBV-associated ACLF not eligible for LT were enrolled in our study. They were allocated to receive either plasma exchange centered ALSS plus standard medical therapy (SMT) (ALSS group, n = 104) or SMT alone (control group, n = 130). All the patients were followed-up for at least 5 years, or until death. At 90 days, the survival rate of ALSS group was higher than that of the control group (62/104 [60%] vs 61/130 [47%], respectively; P < 0.05). Median survival was 879 days in the ALSS group (43% survival at 5 years) and 649 days in the control group (31% survival at 5 years, log-rank P < 0.05). ALSS was found to be associated with favorable outcome of these patients by both univariate and multivariate analysis. Multivariate Cox regression analysis also revealed that lower serum sodium levels, higher grades of encephalopathy, presence of cirrhosis, hepatorenal syndrome, and higher model for end-stage liver disease scores were independent predictors for both 90-day and 5-year mortality due to ACLF. Our findings suggest that ALSS is safe and may improve the short- and long-term prognosis of patients with HBV-associated ACLF.
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spelling pubmed-46031162015-10-27 Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience Qin, Gang Shao, Jian-Guo Wang, Bin Shen, Yi Zheng, Jian Liu, Xian-Jin Zhang, You-Yi Liu, Yan-Mei Qin, Yan Wang, Lu-Jun Medicine (Baltimore) 4500 For patients with acute-on-chronic liver failure (ACLF), artificial liver support system (ALSS) may help prolong lifespan and function as a bridge to liver transplantation (LT), but data on its long-term benefit are lacking. We conducted this prospective, controlled study to determine the efficacy of ALSS and the predictors of mortality in patients with hepatitis B virus (HBV)-associated ACLF. From January 2003 to December 2007, a total of 234 patients with HBV-associated ACLF not eligible for LT were enrolled in our study. They were allocated to receive either plasma exchange centered ALSS plus standard medical therapy (SMT) (ALSS group, n = 104) or SMT alone (control group, n = 130). All the patients were followed-up for at least 5 years, or until death. At 90 days, the survival rate of ALSS group was higher than that of the control group (62/104 [60%] vs 61/130 [47%], respectively; P < 0.05). Median survival was 879 days in the ALSS group (43% survival at 5 years) and 649 days in the control group (31% survival at 5 years, log-rank P < 0.05). ALSS was found to be associated with favorable outcome of these patients by both univariate and multivariate analysis. Multivariate Cox regression analysis also revealed that lower serum sodium levels, higher grades of encephalopathy, presence of cirrhosis, hepatorenal syndrome, and higher model for end-stage liver disease scores were independent predictors for both 90-day and 5-year mortality due to ACLF. Our findings suggest that ALSS is safe and may improve the short- and long-term prognosis of patients with HBV-associated ACLF. Wolters Kluwer Health 2014-12-02 /pmc/articles/PMC4603116/ /pubmed/25526495 http://dx.doi.org/10.1097/MD.0000000000000338 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 4500
Qin, Gang
Shao, Jian-Guo
Wang, Bin
Shen, Yi
Zheng, Jian
Liu, Xian-Jin
Zhang, You-Yi
Liu, Yan-Mei
Qin, Yan
Wang, Lu-Jun
Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title_full Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title_fullStr Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title_full_unstemmed Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title_short Artificial Liver Support System Improves Short- and Long-Term Outcomes of Patients With HBV-Associated Acute-on-Chronic Liver Failure: A Single-Center Experience
title_sort artificial liver support system improves short- and long-term outcomes of patients with hbv-associated acute-on-chronic liver failure: a single-center experience
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603116/
https://www.ncbi.nlm.nih.gov/pubmed/25526495
http://dx.doi.org/10.1097/MD.0000000000000338
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