Evaluating the Effect of Artificial Liver Support on Acute-on-Chronic Liver Failure Using the Quantitative Difference Algorithm: Retrospective Study

Tinghuai Huang; Jianwei Huang; Timon Cheng-Yi Liu; Meng Li; Rui She; Liyu Liu; Hongguang Qu; Fei Liang; Yuanjing Cao; Yuanzheng Chen; Lu Tang

doi:10.2196/45395

Evaluating the Effect of Artificial Liver Support on Acute-on-Chronic Liver Failure Using the Quantitative Difference Algorithm: Retrospective Study

JMIR Form Res. 2023 Oct 24:7:e45395. doi: 10.2196/45395.

Authors

Affiliations

¹ School of Physical Education and Sports Science, South China Normal University, Guangzhou, China.
² Department of Gastroenterology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
³ Civil Aviation Flight University of China, Chengdu, China.

PMID: 37874632
PMCID: PMC10630873
DOI: 10.2196/45395

Abstract

Background: Liver failure, including acute-on-chronic liver failure (ACLF), occurs mainly in young adults and is associated with high mortality and resource costs. The prognosis evaluation is a crucial part of the ACLF treatment process and should run through the entire diagnosis process. As a recently proposed novel algorithm, the quantitative difference (QD) algorithm holds promise for enhancing the prognosis evaluation of ACLF.

Objective: This study aims to examine whether the QD algorithm exhibits comparable or superior performance compared to the Model for End-Stage Liver Disease (MELD) in the context of prognosis evaluation.

Methods: A total of 27 patients with ACLF were categorized into 2 groups based on their treatment preferences: the conventional treatment (n=12) and the double plasma molecular absorption system (DPMAS) with conventional treatment (n=15) groups. The prognosis evaluation was performed by the MELD and QD scoring systems.

Results: A significant reduction was observed in alanine aminotransferase (P=.02), aspartate aminotransferase (P<.001), and conjugated bilirubin (P=.002), both in P values and QD value (Lτ>1.69). A significant decrease in hemoglobin (P=.01), red blood cell count (P=.01), and total bilirubin (P=.02) was observed in the DPMAS group, but this decrease was not observed in QD (Lτ≤1.69). Furthermore, there was a significant association between MELD and QD values (P<.001). Significant differences were observed between groups based on patients' treatment outcomes. Additionally, the QD algorithm can also demonstrate improvements in patient fatigue. DPMAS can reduce alanine aminotransferase, aspartate aminotransferase, and unconjugated bilirubin.

Conclusions: As a dynamic algorithm, the QD scoring system can evaluate the therapeutic effects in patients with ACLF, similar to MELD. Nevertheless, the QD scoring system surpasses the MELD by incorporating a broader range of indicators and considering patient variability.

Keywords: DPMAS; acute-on-chronic liver failure; double plasma molecular absorption system; quantitative difference.

©Tinghuai Huang, Jianwei Huang, Timon Cheng-Yi Liu, Meng Li, Rui She, Liyu Liu, Hongguang Qu, Fei Liang, Yuanjing Cao, Yuanzheng Chen, Lu Tang. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.10.2023.