Effects of artificial liver support systems on nosocomial infections and mortality in non-transplanted liver failure patients.

Abstract

Introduction and objectives: Artificial liver support systems (ALSS) offer a technical solution for patients with liver failure (LF), serving as a bridge to recovery or transplantation. However, the number of LF patients eligible for transplants is limited. This study investigates the incidence of nosocomial infections and survival outcomes in LF patients treated with ALSS who do not undergo liver transplantation.

Patients and methods: A retrospective cohort study was conducted on LF patients receiving standard medical care (SMC) with ALSS versus those treated only with SMC. General and laboratory data were collected from all LF patients. A logistic regression model was used to assesse the risk of nosocomial infections associated with ALSS use, while Cox proportional hazards models was used to evaluate mortality risk in LF patients undergoing ALSS treatment. Survival times for both groups were calculated using Kaplan-Meier analysis.

Results: A total of 306 LF patients were analyzed, comprising 200 males (65.4%) and 106 females (34.6%), with an average age of 49.9 years (95% CI = 48.2-51.6). Multivariate logistic regression analysis showed that ALSS was not linked to the risk of nosocomial infections (odds ratio =1.189, 95%CI=0.442-3.202, p=0.732). However, hazard ratio (HR) results indicated that ALSS is a protective factor for survival in LF patients (HR=0.533, 95%CI=0.374-0.760, p=0.001), supported by Kaplan-Meier curve analysis demonstrating prolonged survival time in the ALSS group among LF patients.

Conclusions: ALSS is not an independent risk factor for nosocomial infections and could effectively prolong the lifespan of LF patients without liver transplantation. Further intervention studies are needed to validate these findings.