Efficacy and safety analysis of double plasma molecular adsorption system plus plasma exchange for treating acute-on-chronic liver failure

OBJECTIVE: This retrospective study aimed to evaluate the efficacy and safety of the double plasma molecular adsorption system (DPMAS) plus plasma exchange (PE) in treating acute-on-chronic liver failure (ACLF). METHODS: A total of 200 ACLF patients were enrolled and divided into two groups: the control group received PE therapy alone, while the observation group received DPMAS in addition to PE. Clinical data were collected from both groups, including treatment efficacy, safety, clinical indicators, symptom improvement, liver function, coagulation function, electrolytes, nutritional status, inflammatory markers, and short-term prognosis (assessed by the Model for End-Stage Liver Disease (MELD) score), and 12-week survival rate. RESULTS: Compared to the control group, the observation group showed notably higher total effective rates and greater symptom improvement at 4 weeks post-treatment. The fluctuation range of all coagulation indices after treatment was smaller in the observation group relative to the control group. Moreover, after treatment, the observation group showed a smaller number of PE treatments, less plasma volume used, and shorter length of hospital stay compared to the control group, as well as lower liver function indicator levels and MELD scores. CONCLUSION: DPMAS combined with PE therapy demonstrates definite efficacy in ACLF treatment without increasing side effects.