Document Detail


The curative effect of ALSS on 1-month mortality in AoCLF patients after 72 to 120 hours.
MedLine Citation:
PMID:  17992652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatitis B virus (HBV)-related acute-on-chronic liver failure (AoCLF) is associated with a high mortality rate. An artificial liver support system (ALSS) creates a better environment for the self-regeneration of retained hepatocytes. AIM AND PATIENTS: We investigated the curative effect of ALSS on 1-month mortality at 72-120 h post-ALSS in 289 AoCLF patients. METHODS: Of the 289 patients, 117 who survived for at least 1 month post-ALSS comprised the survival group; the remaining cases who died within 1 month served as controls. The improvements in laboratory data and clinical syndromes at 72-120 h post-ALSS were compared with those at 24 h. RESULTS: Total bilirubin, international normalized ratio, and creatinine levels, and encephalopathy were significantly improved at 24 h post-ALSS in both the groups (p<0.05); however, these variables showed deterioration at 72-120 h; a rebound occurred in the nonsurvivors (p>0.05). The improvements in these variables in the nonsurvivors were considerably smaller than those in the survivors (p<0.05), particularly at 72-120 h. One-month mortality was more accurately predicted by the logistic regression model at 72-120 h than at 24 h. CONCLUSIONS: The prognosis of AoCLF patients was highly dependent on the improvement in encephalopathy, total bilirubin, international normalized ratio, and creatinine levels at 72-120 h post-ALSS. These variables are useful, therefore, as disease severity indexes to determine organ allocation priorities for liver transplant.
Authors:
Y-S Chen; Z-W Wu; J-Q He; J Yu; S-G Yang; Y-M Zhang; W-B Du; H-C Cao; L-J Li
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  30     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-11-09     Completed Date:  2008-01-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  906-14     Citation Subset:  IM    
Affiliation:
State Key Laboratory of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bilirubin / blood
Biological Markers
Case-Control Studies
China / epidemiology
Creatinine / blood
Female
Hepatic Encephalopathy / therapy
Hepatitis B, Chronic / complications*
Humans
International Normalized Ratio
Liver Failure, Acute / mortality,  physiopathology,  therapy*
Liver, Artificial*
Male
Middle Aged
Prognosis
Prospective Studies
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 60-27-5/Creatinine; 635-65-4/Bilirubin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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