Establishment of artificial liver support by on-line hemodiafiltration for patients with acute liver failure

Abstract

Background: We introduced a new artificial liver support (ALS), on-line hemodiafiltration, in patients with acute liver failure (ALF).
Methods: This case series study was conducted from May 2001 to March 2011. Twenty-eight patients were treated with ALS including daily on-line hemodiafiltration and plasma exchange.
Results: After 4.2±0.5 (mean±SD) sessions, 89.3% of patients completely recovered from encephalopathy and maintained consciousness until discontinuation of ALS. Significant correlation was observed between the degree of encephalopathy and number of sessions required for recovery of consciousness. Ten patients fully recovered, 6 died of complications of ALF except brain edema, and 4 received liver transplantation, 5 died without transplantation after discontinuation of ALS. The changes of prothrombin time, direct bilirubin/total bilirubin ratio, and serum ammonia level shows good information for prognosis.
Conclusions: On-line hemodiafiltration was effective for the management of encephalopathy in patients with ALF.