Evaluation of the end-stage liver disease model in patients treated with plasma exchange

Objective To observe the changes of model for end-stage liver disease(MELD)in patients treated with artificial liver support system(ALSS)and explore its instructive effects on the prognosis and selection of ALSS.Methods 37 patients in treatment group and 38 patients in control group were included in this study.The biochemical data and MELD score of each patient were monitored.The mortality and its correspondence with the MELD score were analyzed.Results The levels of TBil and creatinine(Cr)in serum and the international normalized ratio of coagulation time(INR)together with the MELD score in patients by ALSS were markedly decrease,with a significant difference between the two groups(P <0.05).The case fatality rate was markedly reduced in treatment group compared with the control group(P < 0.05).Moreover,the case fatality rate in treatment group with MELD score between 20-29 and ≥30was remarkably lower than that in control group(39.1% :81.8%,57.1% :93.8%)(P<0.05).In addition,patients with MELD score between 20-29 possessed a high △case fatality rate compared to those with MELD score ≥30(42.7% :36.7%,P < 0.05).Conclutsions Our data demonstrate that ALSS has beneficial effects on chronic hepatic failure with a reduction in the contents of TBil,Cr,INR and MELD score,and that patients with MELD score between 20-29 possess preferable curative effects.Patients with MELD score between 20-29 should receive ALSS as soon as possible. Key words: Liver,artificial; Chronic hepatic failure; MELD; Fatality rate