Meta-Analysis of Influencing Factors of Mortality in Chinese Patients with Liver Failure Undergoing Plasma Exchange.

Introduction: This meta-analysis aimed to evaluate the determinants that influence mortality of individuals with liver failure who are undergoing the treatment of plasma exchange (PE).

Methods: The search for relevant literature was conducted from the beginning of the database records up to January 5, 2024, encompassing a range of databases such as PubMed, Embase, the Cochrane Library, Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), WanFang, and VIP. For the analysis of continuous variables, the weighted mean difference was utilized, while for categorical variables, the odds ratio was employed. Both statistical measures were presented alongside their respective 95% confidence intervals. Subgroup analyses were conducted based on liver failure type, volume of plasma exchanged, and HBV etiology.

Results: In total, 33 studies involving 5,842 patients were included. Older age, a higher Model for End-Stage Liver Disease score, the presence of hepatic encephalopathy, cirrhosis, hepatorenal syndrome, and peritonitis, elevated aspartate transaminase levels, low albumin level, low prothrombin activity, prolonged prothrombin time, low platelet, and white blood cell counts were associated with mortality in Chinese patients with liver failure who underwent PE (all p < 0.05). However, these influencing factors could vary depending on the type of liver failure and the exchange volume during PE.

Conclusion: Several demographic indicators, liver function indicators, coagulation indicators, and routine blood are associated with mortality in patients with liver failure undergoing PE. This study may provide important clinical guidance for the care of patients with liver failure, helping to improve patient survival.