Efficacy of DPMAS combined with PE in improving survival outcomes of patients with acute hepatitis E-induced liver failure: A retrospective cohort analysis

iLIVER Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI:10.1016/j.iliver.2025.100203

Rujia Tang , Yingjie Ji , Hongyu Yao , Xia Zhou , Danni Feng , Eddie C. Cheung , Hongling Liu , Kaili Wang

{"title":"Efficacy of DPMAS combined with PE in improving survival outcomes of patients with acute hepatitis E-induced liver failure: A retrospective cohort analysis","authors":"Rujia Tang , Yingjie Ji , Hongyu Yao , Xia Zhou , Danni Feng , Eddie C. Cheung , Hongling Liu , Kaili Wang","doi":"10.1016/j.iliver.2025.100203","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><div>Acute hepatitis E can progress to liver failure with high mortality and limited treatment options. This study aimed to evaluate the clinical efficacy and safety of the Double Plasma Molecular Adsorption System (DPMAS) combined with plasma exchange (PE) in individuals with acute hepatitis E-induced liver failure.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on hospitalized patients with acute hepatitis E-induced liver failure admitted from January 2011 to December 2023. Ninety-three patients were enrolled and assigned to either a control group (<em>n</em> = 36), receiving standard medical therapy, or a treatment group (<em>n</em> = 57), receiving artificial liver support therapy with DPMAS combined with PE. Liver function parameters, coagulation indices, Model for End-Stage Liver Disease (MELD) scores, and survival rates were compared. Adverse reactions in the treatment group were recorded and evaluated.</div></div><div><h3>Results</h3><div>The treatment group demonstrated significantly greater improvement in liver function and coagulation parameters than the control group. MELD score reduction was more pronounced in the treatment group (−6.78 ± 2.45 vs. −2.59 ± 1.98, <em>p</em> < 0.001). The 6-month survival rate was also higher (87.7% vs. 80.5%, <em>p</em> = 0.038). Cox regression identified age ≥60 years (HR = 2.15), liver cirrhosis (HR = 2.41), infection (HR = 3.15), hepatic encephalopathy (HR = 2.87), ascites (HR = 1.94), and international normalized ratio (INR) ≥1.5 (HR = 2.54) as independent risk factors for poor prognosis, while higher serum albumin level (HR = 0.49) and DPMAS combined with PE (HR = 0.47) were protective. A total of eight adverse reactions were mild and infrequent, including transient hypotension (5.3%) and mild allergic reactions (8.8%), and resolved with symptomatic treatment without interrupting therapy.</div></div><div><h3>Conclusion</h3><div>DPMAS combined with PE is a safe and effective therapeutic modality for acute hepatitis E-induced liver failure, improving liver function, reducing MELD scores, and enhancing survival outcomes. MELD score may serve as a valuable tool to guide treatment stratification and predict prognosis.</div></div>","PeriodicalId":100657,"journal":{"name":"iLIVER","volume":"4 4","pages":"Article 100203"},"PeriodicalIF":0.0000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"iLIVER","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772947825000611","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/5 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Background and aims

Acute hepatitis E can progress to liver failure with high mortality and limited treatment options. This study aimed to evaluate the clinical efficacy and safety of the Double Plasma Molecular Adsorption System (DPMAS) combined with plasma exchange (PE) in individuals with acute hepatitis E-induced liver failure.

Methods

A retrospective analysis was performed on hospitalized patients with acute hepatitis E-induced liver failure admitted from January 2011 to December 2023. Ninety-three patients were enrolled and assigned to either a control group (n = 36), receiving standard medical therapy, or a treatment group (n = 57), receiving artificial liver support therapy with DPMAS combined with PE. Liver function parameters, coagulation indices, Model for End-Stage Liver Disease (MELD) scores, and survival rates were compared. Adverse reactions in the treatment group were recorded and evaluated.

Results

The treatment group demonstrated significantly greater improvement in liver function and coagulation parameters than the control group. MELD score reduction was more pronounced in the treatment group (−6.78 ± 2.45 vs. −2.59 ± 1.98, p < 0.001). The 6-month survival rate was also higher (87.7% vs. 80.5%, p = 0.038). Cox regression identified age ≥60 years (HR = 2.15), liver cirrhosis (HR = 2.41), infection (HR = 3.15), hepatic encephalopathy (HR = 2.87), ascites (HR = 1.94), and international normalized ratio (INR) ≥1.5 (HR = 2.54) as independent risk factors for poor prognosis, while higher serum albumin level (HR = 0.49) and DPMAS combined with PE (HR = 0.47) were protective. A total of eight adverse reactions were mild and infrequent, including transient hypotension (5.3%) and mild allergic reactions (8.8%), and resolved with symptomatic treatment without interrupting therapy.

Conclusion

DPMAS combined with PE is a safe and effective therapeutic modality for acute hepatitis E-induced liver failure, improving liver function, reducing MELD scores, and enhancing survival outcomes. MELD score may serve as a valuable tool to guide treatment stratification and predict prognosis.

查看原文本刊更多论文

DPMAS联合PE改善急性戊型肝炎肝衰竭患者生存结局的疗效：一项回顾性队列分析

背景和目的急性戊型肝炎可发展为肝功能衰竭，死亡率高，治疗方案有限。本研究旨在评价双血浆分子吸附系统（DPMAS）联合血浆置换（PE）治疗急性戊型肝炎肝衰竭的临床疗效和安全性。方法对2011年1月至2023年12月收治的急性戊型肝炎肝衰竭患者进行回顾性分析。93例患者入组，分为对照组（n = 36）和治疗组（n = 57），对照组接受标准药物治疗，治疗组接受DPMAS联合PE的人工肝支持治疗。比较肝功能参数、凝血指标、终末期肝病模型（MELD）评分和生存率。记录并评价治疗组的不良反应。结果治疗组肝功能、凝血指标改善明显高于对照组。治疗组MELD评分降低更为明显（- 6.78±2.45比- 2.59±1.98,p < 0.001）。6个月生存率也较高（87.7% vs. 80.5%, p = 0.038）。Cox回归分析发现，年龄≥60岁（HR = 2.15）、肝硬化（HR = 2.41）、感染（HR = 3.15）、肝性脑病（HR = 2.87）、腹水（HR = 1.94）、国际标准化比值(INR)≥1.5 （HR = 2.54）是预后不良的独立危险因素，而血清白蛋白水平升高（HR = 0.49）和DPMAS合并PE （HR = 0.47）是保护因素。共有8例不良反应轻微少见，包括短暂性低血压（5.3%）和轻度过敏反应（8.8%），均经对症治疗而不中断治疗。结论dpmas联合PE治疗急性戊型肝炎肝衰竭是一种安全有效的治疗方式，可改善肝功能，降低MELD评分，提高生存结局。MELD评分可作为指导治疗分层和预测预后的重要工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

iLIVER

CiteScore

0.60

自引率

0.00%

发文量