Artificial liver treatment improves survival in patients with hepatitis B-related acute-on-chronic liver failure: a case-control matched analysis

Hepatology Research : the Official Journal of the Japan Society of Hepatology
Lingling YangChinese Group on the Study of Severe Hepatitis B (COSSH)

Abstract

The artificial liver support system (ALSS) is recognized as a bridge to liver transplantation (LT) in hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients. However, patient survival remains unknown. We aim to assess the effects of ALSS on survival in HBV-ACLF patients. The clinical data of HBV-ACLF patients receiving standard medical treatment (SMT) plus ALSS (ALSS group, n=507) or only SMT (SMT group, n=417) were collected for survival assessment. The main endpoints were cumulative survival rates at days 21, 28 and 90. Four different rigorous analyses were performed to reduce bias and confounding. In the entire cohort, the cumulative survival rates at days 21, 28 and 90 were significantly higher in patients who underwent ALSS treatment (73.3% vs. 59.6%, 69.2% vs. 56.6%, 56.5% vs. 49.1%, respectively, P<0.01) than in those who underwent SMT only. In the 276-pair case-control matched cohort, a significantly higher survival rate was also observed in the ALSS group than in the SMT group on days 21, 28 and 90 (72.5% vs. 60.3%, 68.3% vs. 57.4%, 55.9% vs. 48.5%, respectively, P<0.05), especially in patients with ACLF-1 and -2. By a multivariable-adjusted analysis, ALSS treatment was associated with a significa...Continue Reading

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