Combination of Plasma Exchange and Adsorption Versus Plasma Exchange in Pediatric Acute Liver Failure

作者：Qian Gao, Jie Chen, Chun Zhao, Jing Li, Aiqin Song, Zhaohua Zhang, Xia Lin, Shengying Dong, Meiyun Xin, Jian Hou, Mingying Han, Xiaomei Li, Xinli Yang, Youpeng Jin, Yucai Zhang · 发表于：Journal of Pediatric Gastroenterology and Nutrition · 年份：2023 · DOI：10.1097/mpg.0000000000003759 · 被引用次数：15 · 研究领域：Liver Disease and Transplantation、Complement system in diseases、Acute Kidney Injury Research

OBJECTIVES: This study aimed to compare the efficacy of double plasma molecular adsorption system (DPMAS) with half-dose plasma exchange (PE) to that of full-dose PE in pediatric acute liver failure (PALF). METHODS: This multicenter, retrospective cohort study was conducted in 13 pediatric intensive care units in Shandong Province, China. DPMAS+PE and single PE therapies were performed in 28 and 50 cases, respectively. The patients' clinical information and biochemical data were obtained from the patients' medical records. RESULTS: The severity of illness did not differ between the 2 groups. At 72 hours after treatment, comparing with PE group, the rates of decline of Pediatric model for End-stage Liver Disease and Pediatric Sequential Organ Failure Assessment scores as well as total bilirubin blood ammonia and interleukin-6 were significantly higher, while the short-term effective rate (75.0% vs 44.0%, P = 0.008) was significantly higher in the DPMAS+PE group. The volume of plasma consumption (26.5 vs 51.0 mL/kg, P = 0.000) and the rate of adverse events (3.6% vs 24.0%, P = 0.026) were lower in the DPMAS+PE group than in the PE group, respectively. However, there was no statistical difference in the 28-day mortality between the 2 groups (21.4% vs 40.0%, P > 0.05). CONCLUSIONS: For PALF patients, both DPMAS + half-dose PE and full-dose PE could improve the liver function, while DPMAS + half-dose PE could significantly reduce plasma consumption without obvious adverse effects ...