Abstract: SA-PO421
Clinical Efficacy of Fractionated Plasma Separation and Adsorption Integrated With Continuous Veno-Venous Hemofiltration in Patients With Liver Failure
Session Information
- Hemodialysis and Frequent Dialysis: Clearance, Technology, Infection
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Dong, Jianhua, JinLing Hospital, Nanjing, Jiangsu, China
- Huang, Li, JinLing Hospital, Nanjing, Jiangsu, China
- Fan, Wenjing, JinLing Hospital, Nanjing, Jiangsu, China
- Ge, Yongchun, JinLing Hospital, Nanjing, Jiangsu, China
Background
To observe the clinical efficacy and safety of fractionated plasma separation and adsorption integrated with continuous veno-venous hemofiltration (FPSA-CVVH) treatment on patients with liver failure.
Methods
In this retrospective study, we enrolled patients with acute or acute-on-chronic liver failure (serum total bilirubin>171.0μmol/L or MELD Score>18) hospitalized from 2015 to 2021. All patients received the treatment of FPSA-CVVH. The extracorporeal circulation connection is shown in Figure 1.Anticoagulation was provided with LMWH or citrate. The main efficacy evaluation index was bilirubin reduction ratios per session (RRs) .
Results
78 patients with acute (n=74) or acute-on-chronic (n=4) liver failure were enrolled.Total bilirubin at baseline was 377.0±101.6 μmol/L, direct bilirubin was 279.3±78.7μmol/L and indirect bilirubin was 59.7±27.4μmol/L.187 sessions of FPSA-CVVH treatment were performed. After a single session total bilirubin (364.8±104.5μmol/L vs 170.8±57.3μmol/L), direct bilirubin (262.4±86.5μmol/L vs 102.5±46.4μmol/L) and indirect bilirubin (62.3±27.7μmol/L vs 35.9±14.8 μmol/L) significantly decreased. RRs was 52.0±7.6% for total bilirubin, 59.4±13.0% for direct bilirubin and 36.9±15.4% for indirect bilirubin. Mean arterial pressure and heart rate remained stable during the treatment. 2 patients changed the filters due to blood coagulation. And another 2 patients exhibited bleeding (gastrointestinal bleeding and Oozing bleeding).29 patients (37.2%) survived in discharging from hospital, 12 patients had recovered liver function,and the remaining 17 patients still needed intermittent artificial liver support therapy.
Conclusion
FPSA-CVVH treatment was a novol and effective artificial liver support therapy in patients with liver failure.Thus, it may be considered as a “bridge technique” to the recovery of liver and renal function in critical ill patients with liver failure.
Figure 1. Schematic diagram of combined continuous veno-venous hemofiltration- bilirubin adsorption