Abstract:

BACKGROUND: Artificial liver support system has been commonly used to treat severe hepatitis. However, their effects are varied, and treatment effect evaluation is not uniform.
OBJECTIVE: To evaluate the curative effect of molecular adsorbents recycling system (MARS) and plasma exchange (PE) in the treatment of severe hepatitis.
METHODS: A total of 143 patients with severe hepatitis were treated with MARS or PE. Blood chemical data, scores of model for end-stage liver disease (MELD), and fatality rate in 3 months were analyzed.
RESULTS AND CONCLUSION: MARS and PE therapy significantly decreased total bilirubin (TBIL), bile acid (TBA), prothrombin time, international normalized ratio for prothrombin time and the score of MELD (P < 0.05), but increased prothrombin activity   (P < 0.05). PE had obvious dominance in improving TBIL, alanine transarninase, prothrombin time, activated partial thromboplastin time, prothrombin activity, prothrombin time and MELD (P < 0.05), while MARS had better ability in improving the creatinine, TBA and albumin (P < 0.05). The fatality rate of MARS and PE groups were 63% and 56.5% respectively in 3 months (P > 0.05). But they were lower than the predictable fatality rate (P < 0.05), especially in the group of patients with MELD score less than 30, but for patients with MELD score ≥30, the two treatments did not improve the prognosis. As the hepatic support device, MARS and PE were effective and safe methods for severe hepatitis. MELD can be applied in clinic for evaluating severity, curative effect and indication of hepatic support device treatment.