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Plasma diafiltration therapy in patients with postoperative liver failure
Hajime Nakae1, Yutaka Eguchi, Toyokazu Yoshioka
1Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan. nakaeh@doc.med.akita-u.ac.jp
Summary
Plasma diafiltration (PDF) is a blood purification therapy that showed improved survival rates in patients with postoperative liver failure (PLF). This therapy effectively reduced harmful toxins like bilirubin, BUN, and creatinine.
Area of Science:
- Hepatology
- Nephrology
- Critical Care Medicine
Background:
- Postoperative liver failure (PLF) presents significant mortality challenges.
- Current treatments for PLF have limitations in toxin removal and patient outcomes.
- Blood purification therapies are being explored to manage PLF complications.
Purpose of the Study:
- To evaluate the efficacy of plasma diafiltration (PDF) in patients with postoperative liver failure (PLF).
- To assess the impact of PDF on biochemical markers and survival rates in PLF patients.
- To determine the clinical and economic utility of PDF for PLF management.
Main Methods:
- A prospective, multicenter study involving 11 patients with PLF.
- Plasma diafiltration (PDF) therapy was administered 98 times.
- Patients were stratified by Model for End-Stage Liver Disease (MELD) scores (20-29, 30-39, ≥40).
- Biochemical parameters and survival rates (28-day and 90-day) were analyzed.
Main Results:
- The 28-day survival rate was 45.5%, and the 90-day survival rate was 27.3%.
- Significant reductions in total bilirubin, blood urea nitrogen (BUN), and creatinine were observed post-treatment.
- Total protein levels increased, while albumin levels showed no significant change.
Conclusions:
- Plasma diafiltration (PDF) demonstrates potential as a beneficial blood purification therapy for postoperative liver failure (PLF).
- PDF effectively removes water-soluble and albumin-bound toxins, improving key biochemical markers.
- The therapy offers a potentially cost-effective approach to managing PLF, with implications for patient survival.
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