Vai trò của thay huyết tương trên tỷ lệ sống ngắn hạn ở bệnh nhân suy gan cấp trên nền bệnh gan mạn tính

Abstract

Objective: To evaluate the effectiveness of plasma exchange (PE) on short-term survival in patients with acute-on-chronic liver failure (ACLF). Subject and method: A study describing the series of cases from January 2019 to July 2022, patients admitted to the University Medical Center - Ho Chi Minh City who met diagnostic criteria for ACLF following the criteria of Asian Pacific Association for the Study of the Liver 2019 (APASL) were enrolled. Result: 95 patients (72 patients in the standard medical care (SMC) group and 23 patients in the PE group) met the inclusion criteria. Age, gender, precipitating factors of ACLF, the severity of hepatic encephalopathy, level of albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), sodium, lactate, creatinine, and ammonia were not significantly different between the PE and SMC groups. Compared to patients in the SMC group, patients in the PE group had substantially lower levels of INR, total bilirubin, MELD score, MELD-Na score, and APASL-AARC research consortium (AARC) score. Patients in PE groups also significantly had a higher 30-day survival rate (60.87% vs 36.11%, p=0.036). However, there was no appreciable difference in the 90-day survival rate (39.13% vs. 27.78%, p=0.303). Conclusion: The 30-day survival rate in the PE group was significantly higher, indicating that PE may be an effective treatment in prolonging patient's survival while waiting for a liver transplant.