The Effects of Double Plasma Molecular Adsorption System in Acute on Chronic Liver Failure Patients
Acute-On-Chronic Liver Failure, Acute on Chronic Hepatic Failure
About this trial
This is an interventional treatment trial for Acute-On-Chronic Liver Failure focused on measuring Hemoperfusion, Acute-On-Chronic Liver Failure, Cytokine adsorbant therapy, HA-330
Eligibility Criteria
Inclusion Criteria:
- Age 18 or more
- Diagnosis of Acute ontop chronic liver failure by Asian Pacific association for the study of the liver (APASL) criteria
- Admitted to intensive care unit
Exclusion Criteria:
- Pregnancy
- Received steroid treatment
- Expected dead within 24 hour
- WBC < 500/mm3
- Allergy to DPMAS
- History of organ transplant
- Terminal illness with do not resuscitation order
Sites / Locations
- King Chulalongkorn Memorial HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention
Standard care
Intervention group will receive DPMAS extracorporeal treatment one session per day for 3 consecutive days plus standard therapy. We plan to use blood flow rate of 100-120 ml/hour with filtration fraction for plasma separation of 25-30%. DPMAS circuit consist of Plasmaflo OP cartridge (Asahi Medical, Tokyo, Japan), Ion exchange resin hemoperfusion cartridge (BS330; Jafron, Zhuhai City, China), and Neutral adsorption resin hemoperfusion cartridge (HA330-II; Jafron, Zhuhai City, China) We do not use any anticoagulant.
Standard treatment according to EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure 2017