Prognostic value of inflammatory cytokine levels, clinical efficacy, and prognosis of the hybrid artificial liver support system in chronic liver failure treatment

Background: This study aimed to evaluate the effectiveness and safety of the hybrid artificial liver support system (HALSS) in patients with chronic liver failure (CLF). It also sought to analyze the inflammatory response and patient prognosis. Methods: A total of 126 CLF patients were divided into three treatment groups: plasma exchange (PEG), double plasma molecular adsorption system (DPMASG), and a combination therapy group (CG). Key parameters, including liver and kidney function, blood coagulation, T lymphocyte subgroups, and inflammatory cytokine levels (TNF-a, procalcitonin [PCT], interferon-gamma [IFN-g], IL-2, IL-6, and IL-10), were assessed before and after treatment. The clinical efficacy, adverse reactions, and short-term prognosis were compared across the groups. Results: Compared to PEG and DPMASG, the combination group (CG) showed significant improvement in liver and kidney function markers, including reduced ALT, AST, total bilirubin (TBil), creatinine (Cr), INR, and prothrombin time (PT). Additionally, CG demonstrated increased levels of cholinesterase (ChE), albumin, and prothrombin activity (PTA). The CG group had a higher total clinical efficacy (92.0%) compared to PEG (76.3%) and DPMASG (78.9%). It also showed a lower rate of adverse reactions (8.0%) and improved one-year survival (36.0% vs. 18.4% and 21.1%, respectively). Furthermore, CG had the most favourable effects on inflammatory cytokine levels and T lymphocyte subsets, significantly reducing TNF-a, PCT, IFN-g, IL-2, IL-6, and IL-10. Conclusions: The combination of PEG and DPMAS (HALSS) demonstrated superior clinical efficacy in improving liver and kidney function, reducing inflammation, and enhancing patient prognosis compared to single therapies. These findings support HALSS as a promising adjunctive therapy for CLF patients, improving short-term outcomes and long-term survival.