Artificial Liver Support System Improves One-Year Prognosis of Patients With Hepatitis B Virus-Associated Acute-on-Chronic Liver Failure.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology and Hepatology Pub Date : 2025-01-27 DOI:10.1111/jgh.16883

Xiaoqin Lan, Changze Hong, Xiaofeng Zhang, Ling Zhou, Yuan Li, Caili Zhang, Xingyan Mo, Jing Zhou, Beiling Li, Tingting Qi, Qinjun He, Wenfan Luo, Qintao Lai, Yali Ji, Ying Xu, Junwei Liu, Fuyuan Zhou, Jinjun Chen

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Abstract

Background & aims: Acute-on-chronic liver failure (ACLF) is a complex syndrome with limited treatment options. This study aims to investigate the impact of artificial liver support system (ALSS) on the one-year prognosis of patients with Hepatitis B virus (HBV)-associated ACLF.

Method: A retrospective study was conducted on 239 patients with HBV-ACLF in Nanfang Hospital from January 2016 to June 2021. Patients were divided into the ALSS group (n = 103) and the Standard Medical Therapy (SMT group, n = 136). Demographic, clinical, and laboratory data were collected before the first ALSS treatment for patients in ALSS group, while baseline data were collected in SMT group. According to receiving different ALSS modes, patients in ALSS group were divided into plasma exchange (PE) group and non-PE group.

Result: The 12-week and 1-year liver transplant (LT) free survival rates in the ALSS group were significantly higher than that in the SMT group (65.05% vs 52.21%, p = 0.0011; 63.11% vs. 48.53%, p = 0.0006). ALSS therapy was the independent predictive factors associated with 12-week and 1-year mortality (hazard ratio, HR: 0.59, p = 0.04, and HR: 0.54, p = 0.01). Comparatively more ALSS-related complications were observed in PE group. After Propensity Score Matching, the 12-week and 1-year LT-free survival rates between PE and non-PE group were similar (88% vs. 80%, p = 0.227, 88% vs. 80%, p = 0.227).

Conclusion: ALSS therapy is a safe and effective treatment for HBV-ACLF. ALSS improves 1-year prognosis of patients with HBV-ACLF.

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人工肝支持系统改善了乙型肝炎病毒相关急性慢性肝衰竭患者的一年预后。

背景与目的：急性慢性肝衰竭（ACLF）是一种复杂的综合征，治疗方案有限。本研究旨在探讨人工肝支持系统（ALSS）对乙型肝炎病毒（HBV）相关 ACLF 患者一年预后的影响：方法：对南方医院2016年1月至2021年6月的239例HBV-ACLF患者进行回顾性研究。患者被分为ALSS组（103人）和标准药物治疗组（136人）。ALSS组患者在首次ALSS治疗前收集人口统计学、临床和实验室数据，SMT组患者收集基线数据。根据接受不同的ALSS模式，ALSS组患者被分为血浆置换（PE）组和非PE组：结果：ALSS组的12周和1年无肝移植（LT）生存率明显高于SMT组（65.05% vs 52.21%，P = 0.0011；63.11% vs. 48.53%，P = 0.0006）。ALSS疗法是12周和1年死亡率的独立预测因素（危险比，HR：0.59，p = 0.04；HR：0.54，p = 0.01）。在 PE 组中观察到的 ALSS 相关并发症相对较多。倾向评分匹配后，PE组和非PE组的12周和1年无LT生存率相似（88% vs. 80%，P = 0.227；88% vs. 80%，P = 0.227）：结论：ALSS疗法是一种安全有效的HBV-ACLF治疗方法。ALSS可改善HBV-ACLF患者的1年预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.