Prognosis Of Acute Liver Failure Patients Due To Different Etiology Treated With Artificial Liver

BACKGROUND:Acute liver failure(ALF)is complex multisystemic disorder that presented with progressive decrease in hepatic function and psychological changes that develop hepatic encephalopathy progressing from confusion to coma.ALF has high mortality rate and requires immediate efficient and effective treatment.Nowadays,liver transplant has become the most effective treatment so far.By reason of the limited availability and donor resources,many researches have been studied to develop a new technique of treatment.Artificial liver has many functions,such as for detoxification,correction of coagulopathy,suppression of inflammation,and promotion of liver cell regeneration.This could be an alternative procedure to prolong the survival time of ALF patients.The aim of this study is to discover effectiveness of artificial liver system in laboratory parameter for patients ALF with different etiology and to determine the prognostic factors of ALF patients.METHODS:Following patients with ALF admitted from 1st January 2011 to 31st December 2016 total of 197 were measured for inclusion in this study.Written consent was gained from all patients or their relatives.The procedures were approved by the local ethics committee and are in accordance with the Helsinki Declaration.The exclusion criteria for this study were as follows:patients obtained ALS therapy before enrolled to hospital,received transplantation,acute on chronic liver failure,uncontrolled systemic or intracranial bleeding,pregnancy,therapy with angiotensin converting enzyme inhibitors,and severe hypotension.The following laboratory parameters were recorded includes:age,sex,etiology of ALF,survival or death,blood examination,liver serum,INR,APTT,PT and Na Serum.Serum samples from all patients were analyzed to determine the etiology of ALF.Hepatic encephalopathy based on the clinical manifestations.The first analysis is patients with ALF who received artificial liver treatment will become the experimental group and ALF patients which do not receive artificial liver treatment will become the control group.Effectiveness of ALS in patients ALF with different etiology will be analyzed.RESULTS:Liver functions were significantly improve after treatment of ALS.In Dili group showed a significant reduction of the serum creatinine compared with the experimental group,although in both groups were equally showed an improvement of liver function after received ALS.The sessions of ALS presented a positive correlation to the twenty eight day survival rate.CONCLUSION:The ALS therapy is safe and effective for ALF patients.Higher survival rate has been reported that might cause by improvement of laboratory parameters post ALS therapy.Thus,until this moment the artificial liver support still being considered the "bridging tools" to liver transplantation.Additionally,further study is still needed to predict the precise time to start ALS therapy.With several studies showed that ALS has the positive value for the patients with end stage liver disease,hence the function of ALS need to be optimized.