Influence of duration of plasma diafiltration on therapeutic outcome of liver failure

Objective To investigate the influence of different durations of plasma diafiltration ( PDF) on liver function in patients with liver failure and rebound of liver function after treatment. Methods A total of 101 patients with liver failure who were admitted to Beijing You An Hospital, Capital Medical University, from January 2015 to December 2016 were enrolled, and according to the duration of treatment, these patients were divided into 4-hour group with 77 patients and 6-hour group with 24 patients. All patients were given artificial extracorporeal liver support therapy in addition to the medical treatment. The two groups were observed in terms of the reductions in alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , total bilirubin ( TBil) , and direct bilirubin ( DBil) after treatment and the rebound of ALT, AST, TBil, and DBil at 24 and 72 hours after treatment. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results All patients had stable hemodynamics during treatment and no patient experienced adverse events. Some patients complained of staying in bed for a long time and feeling weak. The 6-hour group had a significantly higher intolerance rate than the 4-hour group [41. 7% ( 10/24) vs 6. 5% ( 5/77) , χ2= 17. 90, P < 0. 01].There were no significant differences in the reductions in ALT, AST, TBil, and DBil after PDF treatment between the two groups ( t = 2. 53, -4. 48, -1. 52, and-0. 47, all P > 0. 05) . There were also no significant differences between the two groups in the degrees of rebound of ALT, AST, TBil, and DBil at 24 and 72 hours after treatment ( 24 hours: t =-0. 236, -1. 251, -1. 251, and 0. 943, all P > 0. 05;72 hours: t =-0. 700, 0. 596, -1. 530, and 1. 837, all P > 0. 05) . Conclusion PDF treatment with different durations has similar effect and safety. Therefore, 4-hour PDF can be applied in clinical practice to improve patients' tolerance.