Low-Volume Plasma Exchange Combined With a Double Plasma Molecular Adsorption System is Superior to Standard-Volume Plasma Exchange in improving the MELD Score and Reducing Plasma Consumption in Adult Patients With Acute Liver Failure: A Multicenter Retrospective Cohort Study From Heilongjiang Province.

OBJECTIVE

This research aimed to investigate the disparities in improving the model for end-stage liver disease (MELD) score and plasma volume consumption between standard-volume plasma exchange (SVPE) and low-volume plasma exchange (LVPE) combined with the double plasma molecular adsorption system (DPMAS) in adult patients with acute liver failure (ALF).

METHODS

This multicenter cohort study retrospectively enrolled adult patients with ALF who were admitted to the designated hospitals and received conventional drug treatment along with one or more sessions of SVPE or LVPE combined with DPMAS during hospitalization. According to the different therapeutic plasma exchange (TPE) methods received during hospitalization, the enrolled patients were subsequently classified into the SVPE group and the LVPE combined with DPMAS group. Thereafter, the aforementioned demographic characteristics, laboratory parameters, their change rates, and plasma consumption were compared between different groups or before and after TPE.

RESULTS

In this multicenter retrospective cohort study, 97 adult patients with ALF were recruited, with a male-to-female ratio of 1.06: 1. Subsequently, they were classified into the SVPE group (n = 48) and the LVPE combined with DPMAS group (n = 49). During hospitalization, they received a total of 97 sessions of SVPE and 91 sessions of LVPE combined with DPMAS. There were significant differences in multiple laboratory parameters before the first SVPE or LVPE combined with DPMAS between different groups, yet the MELD score was not involved. The change rates of multiple laboratory parameters, including the MELD score, and plasma consumption displayed significant differences between the SVPE group and the LVPE combined with DPMAS group.

CONCLUSION

In terms of improving the MELD score of patients with ALF and reducing the plasma volume, the combined use of LVPE and DPMAS is more effective than SVPE.