Probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure

Aim. To estimate the validity of probit-analysis for assessing the effectiveness of various treatment methods for chronic liver failure. Methods. The study included 292 patients with chronic liver failure. All patients were distributed to four groups, conventional treatment was performed in all patients. Patients of the 2nd group were additionally administered plasma exchange, of the 3rd group - plasma exchange and high volume continuous veno-venous hemofiltration, of the 4th - molecular adsorbent recirculating system (MARS). To determine the medium lethal time (time at which 50% of patients pass away, ТL50), probit-analysis based on studying the association between the time logarithms and probits corresponding to the observed effects, was used. Results. Standardization of patients’ mortality rate, allowing to exclude biases associated with differences of chronic liver failure severity at admission, was performed. Probit-analysis showed that there were no significant differences in between male and female patients regardless of used treatment methods. ТL50 in patients of any gender treated only by conventional methods was significantly lower compared to other methods of treatment. There was a trend of ТL50 increase in the following sequence: conventional treatment → plasma exchange → plasma exchange and high volume continuous veno-venous hemofiltration → molecular adsorbent recirculating system. Conclusion. Probit-analysis allows to determine the time of 50% mortality (ТL50) in patients with chronic liver failure. Treatment using extracorporeal methods of treatment (plasma exchange, plasma exchange and high volume continuous veno-venous hemofiltration, molecular adsorbent recirculating system) is significantly more effective compared to conventional treatment.

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Treatment of patients with chronic liver failure according to disease etiology

Kazan medical journal ◽

10.17750/kmj2017-58 ◽

2017 ◽

Vol 98 (1) ◽

pp. 58-63

Author(s):

D E Kutepov ◽

I N Pasechnik

Keyword(s):

Liver Failure ◽

Plasma Exchange ◽

High Volume ◽

Chronic Liver ◽

Chronic Liver Failure ◽

Disease Etiology ◽

Group 4 ◽

Molecular Adsorbent Recirculating System ◽

Group 2 ◽

Group 1

Aim. Improving the efficiency of treatment of patients with chronic liver failure by optimizing the application of extracorporeal detoxification methods.Methods. The study included 292 patients with chronic liver failure (188 males and 104 females). The main causes of chronic liver failure were nutritional factor (alcohol abuse), viral liver diseases, and the combination of alcoholic and viral factors. All patients regardless of the disease etiology were divided into groups. Patients in group 1 received standard conservative therapy, aimed at relieving the symptoms of chronic liver failure. Patients in group 2 were additionally administered plasma exchange, in group 3 - PE and high-volume venovenous hemofiltration, and in group 4 - sessions of molecular adsorbent recirculating system (MARS).Results. Mortality of patients with chronic liver failure on conservative treatment accounted for 84.0% and was 1.5-2.1 times higher than in other groups (53% in plasma exchange group, 52% when using plasma exchange and high-volume venovenous hemofiltration and 40.6% in MARS group), these differences being statistically significant when compared with group 1 (χ2 from of 18.3 to 23.4, p <0.05). Indicators, reflecting the time of 50% mortality of patients with chronic liver failure of different etiology, suggest that in chronic liver failure of alcoholic origin plasma exchange and a combination of plasma exchange and high-volume venovenous hemofiltration are the most effective, and in chronic liver failure of viral and mixed etiology the best results are obtained when using MARS.Conclusion. The effectiveness of treatment of patients with chronic liver failure depends on the etiology of the disease: in alcoholic chronic liver failure plasma exchange and a combination of plasma exchange and high-volume venovenous hemofiltration are most rational, and in chronic liver failure of viral and mixed etiology MARS sessions are rational.

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Molecular adsorbent recirculating system: a clinical experience in acute or acute on chronic liver failure (133 sessions)

Critical Care ◽

10.1186/cc7309 ◽

2009 ◽

Vol 13 (Suppl 1) ◽

pp. P145

Author(s):

I Cardeau ◽

L Lavayssiere ◽

MB Nogier ◽

O Cointault ◽

L Rostaing

Keyword(s):

Liver Failure ◽

Clinical Experience ◽

Chronic Liver ◽

Chronic Liver Failure ◽

System A ◽

Molecular Adsorbent Recirculating System ◽

Molecular Adsorbent

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Plasma Exchange in Acute and Acute on Chronic Liver Failure

Seminars in Liver Disease ◽

10.1055/s-0041-1730971 ◽

2021 ◽

Author(s):

Rakhi Maiwall ◽

Shiv K. Sarin

Keyword(s):

Liver Failure ◽

Plasma Exchange ◽

High Volume ◽

Chronic Liver ◽

Toxic Substances ◽

Chronic Liver Failure ◽

Liver Support ◽

Basic Premise ◽

Extracorporeal Blood Purification ◽

Purification Technique

AbstractLiver failure in the context of acute (ALF) and acute on chronic liver failure (ACLF) is associated with high mortality in the absence of a liver transplant. For decades, therapeutic plasma exchange (TPE) is performed for the management of immune-mediated diseases. TPE has emerged as an attractive extracorporeal blood purification technique in patients with ALF and ACLF. The basic premise of using TPE is to remove the toxic substances which would allow recovery of native liver functions by facilitating liver regeneration. In recent years, encouraging data have emerged, suggesting the benefits of TPE in patients with liver failure. TPE has emerged as an attractive liver support device for the failing liver until liver transplantation or clinical recovery. The data in patients with ALF suggest routine use of high-volume TPE, while the data for such a strategy are less robust for patients with ACLF.

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