Evaluating the Effect of Artificial Liver Support on Acute-on-Chronic Liver Failure Using the Quantitative Difference Algorithm: Retrospective Study (Preprint)

Abstract

BACKGROUND The prognosis evaluation of liver failure should run through the whole diagnosis. The quantitative difference (QD) may be beneficial in the prognosis evaluation of acute-on-chronic liver failure (ACLF). OBJECTIVE This study aims to verify whether the QD algorithm has the same function or is even better than the Model for End-Stage Liver Disease (MELD). METHODS Conventional treatment (n=12) or double plasma molecular absorption system (DPMAS) with conventional treatment (n=15). The prognosis evaluation was performed by the MELD and QD scoring system. RESULTS A very signification reduction was observed in alanine aminotransferase, aspartate aminotransferase and conjugated bilirubin, both in P-value (P<0.01) and QD (>1.69), and a significant decrease in hemoglobin, red blood cell count and total bilirubin were observed in DPMAS group (P<0.05), but not in QD (≤1.69). Meanwhile, there was a significant association between MELD and QD scores. It significantly differed between groups divided by patients’ status after treatment. Besides, the QD algorithm can also show patients' improvement, such as fatigue and jaundice. CONCLUSIONS Compared with the conventional treatment group, DPMAS can reduce alanine aminotransferase, aspartate aminotransferase and unconjugated bilirubin. As a dynamic algorithm, the QD scoring system can evaluate the therapeutic effect of patients with ACLF, which proves that it has the same function as MELD, but considers more indicators and patient variability.