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Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
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Therapeutic Plasma Exchange in Patients With Acute-On-Chronic Liver Failure Improves Survival-An Updated
Santhosh E Kumar1, Kausala Sithamparapillai2, Ashok Kumar Choudhury3
1Department of Hepatology, Christian Medical College, Vellore, India.
Summary
Plasma exchange (PLEX) significantly improves survival rates for patients with acute-on-chronic liver failure (ACLF). This treatment reduces mortality at 30 days, 90 days, and up to one year compared to standard medical therapy.
Area of Science:
- Hepatology
- Critical Care Medicine
- Immunology
Background:
- Acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by organ failures and high short-term mortality.
- Plasma exchange (PLEX) is an increasingly utilized treatment modality for ACLF patients.
Purpose of the Study:
- To evaluate the efficacy of PLEX in treating patients diagnosed with ACLF.
- To compare survival outcomes between PLEX and standard medical therapy (SMT) in ACLF patients.
Main Methods:
- A systematic review and meta-analysis was conducted, including 23 studies with 5336 ACLF patients.
- Studies compared PLEX versus SMT across various ACLF definitions and etiologies.
- The primary outcome was 30-day survival, analyzed using a random-effects model.
Main Results:
- PLEX significantly reduced 30-day mortality (RR 0.70) and 90-day mortality (RR 0.81) compared to SMT.
- One-year survival also showed improvement with PLEX (RR 0.85).
- Significant mortality reduction was observed in HBV-related and alcohol-related ACLF subgroups; common adverse effects included skin rash and allergic reactions.
Conclusions:
- PLEX offers a significant survival benefit for ACLF patients up to one year post-treatment.
- The findings support PLEX as an effective therapeutic option for improving outcomes in ACLF.
- PLEX demonstrated improved survival across different ACLF definitions and etiologies.
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