Safety and Efficacy of DPMAS in Patients With Acute‐on‐Chronic Liver Failure Based on Different Platelet Count Levels

ABSTRACT To investigate the effect of different platelet (PLT) counts on the safety and efficacy of the double‐plasma molecular absorption system (DPMAS) in patients with acute‐on‐chronic liver failure (ACLF). A total of 156 patients with ACLF receiving DPMAS were divided into the observed group (40 × 10 9 /L ≤ PLT < 50 × 10 9 /L) and the control group (PLT ≥ 50 × 10 9 /L) according to PLT count level. The safety and efficacy indices of bleeding‐related complications, PLT reduction rate, total bilirubin (TBIL) reduction rate, and 28‐days survival rate after DPMAS were analyzed and compared between the two groups. The incidence of bleeding complications during and after DPMAS in the observed and control groups (14.3% vs. 14.9%, p = 0.922), the decline rate of PLT immediately and 24 h after treatment (0.13 vs. 0.11/0.05 vs. 0.09, p = 0.256/0.161), and the 28‐days survival rate after treatment (76.2% vs. 75.4%, p = 0.923) were not significantly different. The thromboelastogram before DPMAS showed no significant difference in PLT function between the two groups ( p > 0.05). Although the TBIL level of the two groups rebounded 24 h after treatment compared with immediately after treatment, it decreased significantly immediately and 24 h after treatment compared with pre‐treatment levels ( p < 0.05). There was no significant difference in the rate of decline of serum TBIL immediately after treatment and 24 h after treatment between the two groups (0.33 vs. 0.35/0.14 vs. 0.16, p = 0.193 and 0.653, respectively). DPMAS is safe and effective in patients with ACLF with 40 × 10 9 /L ≤ PLT count < 50 × 10 9 /L.