Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series

Abstract Background Pediatric acute liver failure (PALF) is a life-threatening condition with no definitive treatment. This study evaluated the combined use of the dual plasma molecular adsorption system (DPMAS) and plasma exchange (PE) to improve liver function and survival outcomes in PALF patient...

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Main Authors: Jia-Hao Geng, Shi-Lin Liu, Bao-Fan Dou, Jun-Lin Zhao, He-Kai Ma, Zhi-Yuan Wang, Shu-Jun Li
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05520-z
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author Jia-Hao Geng
Shi-Lin Liu
Bao-Fan Dou
Jun-Lin Zhao
He-Kai Ma
Zhi-Yuan Wang
Shu-Jun Li
author_facet Jia-Hao Geng
Shi-Lin Liu
Bao-Fan Dou
Jun-Lin Zhao
He-Kai Ma
Zhi-Yuan Wang
Shu-Jun Li
author_sort Jia-Hao Geng
collection DOAJ
description Abstract Background Pediatric acute liver failure (PALF) is a life-threatening condition with no definitive treatment. This study evaluated the combined use of the dual plasma molecular adsorption system (DPMAS) and plasma exchange (PE) to improve liver function and survival outcomes in PALF patients. Methods A retrospective study was conducted on 7 PALF patients treated with DPMAS and PE. Data on liver function scores (Liver Injury Unit [LIU], Model for End-Stage Liver Disease [MELD], Model for End-Stage Liver Disease with Sodium [MELD-Na], MELD 3.0), bilirubin levels, and coagulation indices were collected before and after treatment. Results DPMAS and PE treatments significantly reduced total bilirubin (382.2 µmol/L to 52.0 µmol/L) and improved coagulation indices. Liver injury scores decreased notably (e.g., LIU from 184 to 52 in one case). Five patients recovered, while two with severe comorbidities showed limited improvement. Conclusion The combination of DPMAS and PE therapy improves liver function and survival outcomes in PALF. These results support its use as a bridge to recovery or transplantation in PALF patients, though further studies with larger sample sizes are needed.
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spelling doaj-art-e231ef36bc3a42c7bb72b8ce3f5280f42025-08-20T02:59:57ZengBMCBMC Pediatrics1471-24312025-03-012511710.1186/s12887-025-05520-zPreliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case seriesJia-Hao Geng0Shi-Lin Liu1Bao-Fan Dou2Jun-Lin Zhao3He-Kai Ma4Zhi-Yuan Wang5Shu-Jun Li6Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityDepartment of Pediatrics, The First Affiliated Hospital of Xinxiang Medical UniversityAbstract Background Pediatric acute liver failure (PALF) is a life-threatening condition with no definitive treatment. This study evaluated the combined use of the dual plasma molecular adsorption system (DPMAS) and plasma exchange (PE) to improve liver function and survival outcomes in PALF patients. Methods A retrospective study was conducted on 7 PALF patients treated with DPMAS and PE. Data on liver function scores (Liver Injury Unit [LIU], Model for End-Stage Liver Disease [MELD], Model for End-Stage Liver Disease with Sodium [MELD-Na], MELD 3.0), bilirubin levels, and coagulation indices were collected before and after treatment. Results DPMAS and PE treatments significantly reduced total bilirubin (382.2 µmol/L to 52.0 µmol/L) and improved coagulation indices. Liver injury scores decreased notably (e.g., LIU from 184 to 52 in one case). Five patients recovered, while two with severe comorbidities showed limited improvement. Conclusion The combination of DPMAS and PE therapy improves liver function and survival outcomes in PALF. These results support its use as a bridge to recovery or transplantation in PALF patients, though further studies with larger sample sizes are needed.https://doi.org/10.1186/s12887-025-05520-zPediatric acute liver failurePlasma exchangeDual plasma molecular adsorption systemHyperbilirubinemiaLiver function
spellingShingle Jia-Hao Geng
Shi-Lin Liu
Bao-Fan Dou
Jun-Lin Zhao
He-Kai Ma
Zhi-Yuan Wang
Shu-Jun Li
Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
BMC Pediatrics
Pediatric acute liver failure
Plasma exchange
Dual plasma molecular adsorption system
Hyperbilirubinemia
Liver function
title Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
title_full Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
title_fullStr Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
title_full_unstemmed Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
title_short Preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure: a retrospective case series
title_sort preliminary experience of combined dual plasma molecular adsorption system and plasma exchange in pediatric acute liver failure a retrospective case series
topic Pediatric acute liver failure
Plasma exchange
Dual plasma molecular adsorption system
Hyperbilirubinemia
Liver function
url https://doi.org/10.1186/s12887-025-05520-z
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