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Chinese Journal of Blood Purification ›› 2007, Vol. 6 ›› Issue (6) : 317-319.

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Abstract

Objective To evaluate clinical significance, feasibility and safety of plasma exchange combined with continuous veno-venous hemofiltration (PE+ CVVH) in the treatment of severe hepatitis before liver transplantation. Methods Nine patients with severe hepatitis of various causes were treated with PE+ CVVH for 27 times. After comparisons of their liver functions, thrombinogen time, blood ammonia, clinical manifestations, untoward effects before and after (PE+ CVVH), the efficacy and safety of the treatment were evaluated. Results After the treatment, conscious disturbances, jaundice, lassitude, nausea, vomiting, anorexia and abdominal distention were improved significantly. Serum total bilirubin, conjugated bilirubin and blood ammonia decreased by 49.4%, 58.1% and 65.8%, respectively, as compared with those before the treatment. Serum albumin, transaminases, renal functions also improved. Thrombinogen time reduced from (35.18±9.26)% before the treatment to (19.61±10.26) % after the treatment, and bleeding tendency was corrected. There were no changes in WBC, platelet and serum electrolytes. No hemorrhages, shock and hypersensitivity were found, and the patients tolerated PE+CVVH well. Conclusion PE+ CVVH significantly improves clinical symptoms and biochemical abnormalities in patients with severe hepatitis of various causes. It changes short term prognosis of the patients with relatively safety and less side effects. PE+ CVVH can be used as a supportive treatment and as a transitional measure before liver transplantation.