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Braz J Infect Dis. 2013 Jul-Aug;17(4):427-30. doi: 10.1016/j.bjid.2012.11.008. Epub 2013 Jun 27.

Therapeutic effects of blood purification in treatment of fulminant hepatic failure.

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1
No. 5 People's Hospital of Wuxi, Wuxi, Jiangsu Province, China.

Abstract

OBJECTIVES:

To evaluate the clinical effects of blood purification for treating fulminant hepatic failure (FHF).

METHODS:

Thirty-three severe FHF patients with hepatic encephalopathy (HE) above grade III were subjected to a combined blood purification treatment in addition to the comprehensive liver protection therapy. Patients underwent continuous hemofiltration on a daily basis during the daytime followed by sequential treatment with plasma exchange or hemodialysis every 2-3 days. The therapeutic effects of this treatment were evaluated.

RESULTS:

After treatment with blood purification, restoration of consciousness (those who abandoned the treatment without restoration of consciousness were excluded) was achieved in 6 of 8 cases (75%) in acute liver failure (ALF) group, 3 of 3 cases (100%) in subacute liver failure (SALF) group, and 9 of 14 cases (64.29%) in acute/subacute on chronic liver failure (A/SCLF) group. Of all cases, 11 patients restored consciousness after 7 days in a coma. The rate of long-term survival (those who abandoned the treatment were excluded) was 3/7 (42.86%) for ALF group, 2/2 (100%) for SALF group, and 1/11 (9.09%) for A/SCLF group. The levels of hemoglobin and platelet in peripheral blood were significantly reduced after blood purification.

CONCLUSIONS:

Treatment of FHF patients with daily continuous hemofiltration during the daytime is effective in treating HE and in improving health status in the early stages of the disease. Long-term prognosis also benefits from this treatment. The rate of consciousness recovery and long-term survival is highest in SALF group followed by ALF group. This treatment is less effective in A/SCLF patients. It should be noted that blood purification procedure may cause damage to blood cells.

KEYWORDS:

Blood purification; Hepatic encephalopathy; Liver failure; Therapy

PMID:
23810709
DOI:
10.1016/j.bjid.2012.11.008
[Indexed for MEDLINE]
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