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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (3): 548-551. doi: 10.19723/j.issn.1671-167X.2022.03.022

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Effect of artificial liver with double plasma molecular absorb system model on patients' platelets and corresponding treatment strategy

Jin-feng JIA,Fei LIANG*(),Jian-wei HUANG,Hao WANG,Pu-qing HAN   

  1. Department of Gastroenterology, the Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, China
  • Received:2021-04-29 Online:2022-06-18 Published:2022-06-14
  • Contact: Fei LIANG E-mail:ucbzuhy@163.com
  • Supported by:
    Guangdong Medical Science and Technology Research Foundation Project(A2020634)

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Abstract:

Objective: To compare the effects of artificial liver treatment with double plasma molecular adsorption system(DPMAS) mode and traditional plasma exchange (PE) mode on platelets in patients, and to evaluate the clinical efficacy of recombinent human thrombopoietin (rhTPO) in the treatment of thrombocytopenia. Methods: A total of fifteen patients undergoing artificial liver with DPMAS model admitted to the Fifth Affiliated Hospital of Guangzhou Medical University from January 2018 to November 2020 were selected and included in the DPMAS group, and another 15 patients receiving PE were selected and included in the PE group. The improvement of clinical symptoms, such as fatigue, jaundice, oliguria, edema, etc. before and after artificial liver treatment was compared between the two groups, and the trend of blood routine (especially platelet), coagulation function and other indexes before and after treatment were compared between the two groups. The use of rhTPO and the number of platelets were recorded during treatment. Results: The improvement rate of clinical symptoms in DPMAS group was 86.67%, which was higher than that in PE group, but the difference was not statistically significant (P>0.05). There was no statistical significance in the outcome of the two groups within 90 days (P>0.05). There was no significant difference in white blood cell (WBC) and hemoglobin (HB) between the two groups after treatment (P>0.05). However, the level of platelet(PLT) in DPMAS group was significantly lower than that before treatment (P < 0.05), and was significantly lower than that in PE group (P < 0.05). After treatment, the international normalized ratio (INR) level in PE group was significantly improved (P < 0.05), but there was no significant difference in the INR level in DPMAS group (P>0.05). The patients in the DPMAS group received an average of (8.2±3.1) doses of rhTPO and (1.5±0.3) IU of platelet transfusions during hospitalization. In DMPAS group, platelets increased significantly after infusion of terbium. Conclusion: Compared with PE mode, the artificial liver with DPMAS mode can reduce platelet levels in patients, but the application of rhTPO can stimulate platelet regeneration and increase platelet levels in the patients, thereby reducing the risk of bleeding due to platelet hypoplasia.

Key words: Artificial liver, Dual plasma molecular adsorption system, Plasmapheresis, Platelets, Recombinant human thrombopoietin (rhTPO)

CLC Number: 

  • R575.3

Table 1

Comparison of blood routine and coagulation function indexes between the two groups that before and after treatment"

Items PE group (n=15) DPMAS group (n=15) t value P value
WBC/(×109/L) Before treatment 5.68±2.31 5.31±1.98 0.471 0.641
After treatment 6.42±1.83 5.98±2.31 0.578 0.568
Hb/(g/L) Before treatment 10.93±3.23 9.98±2.87 0.852 0.402
After treatment 7.58±2.31* 8.91±2.19* 1.618 0.117
PLT/(×109/L) Before treatment 95.48±11.29 96.51±21.15 0.166 0.869
After treatment 87.31±21.38* 51.02±17.11* 5.133 0.000
INR Before treatment 2.84±0.37 2.97±0.54 0.769 0.448
After treatment 1.47±0.76* 2.85±0.73 5.072 0.000

Table 2

Comparison of biochemical indexes between the two groups that before and after treatment"

Items PE group (n=15) DPMAS group (n=15)
ALT/(U/L) Before treatment 267.33±32.35 259.39±31.78
After treatment 87.52±21.76* 85.90±22.39*
AST/(U/L) Before treatment 180.96±33.43 189.92±32.85
After treatment 77.23±12.36* 88.97±22.10*
TBil/(μmol/L) Before treatment 339.42±44.21 347.50±38.19
After treatment 235.57±27.53* 207.42±26.10*

Figure 1

Changes of platelet (PLT) levels in DPMAS group that before and after used rhTPO Red arrow, start time of infusion of recombinant human thrombopoietin."

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