Nakae Hajime, Eguchi Yutaka, Yoshioka Toyokazu, Yoshimura Noriko, Isono Motohide
Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Ther Apher Dial. 2011 Aug;15(4):406-10. doi: 10.1111/j.1744-9987.2011.00969.x.
Plasma diafiltration (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. A prospective, multicenter study was undertaken to evaluate the changes in biochemical examination of blood and the 28-day and 90-day survival rates of patients with postoperative liver failure (PLF). Eleven patients with PLF were studied with the therapy performed 98 times. The Model for End-Stage Liver Disease (MELD) score was categorized into three grades: 20-29, 30-39, and 40 or higher. The survival rate was assessed by the severity of MELD score. The 28-day survival rate was 45.5% and that at 90 days was 27.3%. The levels of total bilirubin, BUN, and creatinine decreased significantly after treatment. On the other hand, the levels of total protein increased after treatment and those of albumin did not change significantly. PDF may be the useful blood purification therapies for use in cases of PLF in terms of medical economics and the removal of water-soluble and albumin-bound toxins.
血浆滤过透析（PDF）是一种血液净化疗法，即在使用选择性膜血浆分离器进行单纯血浆置换（PE）时，透析液在中空纤维外部流动。开展了一项前瞻性多中心研究，以评估术后肝衰竭（PLF）患者血液生化检查的变化以及28天和90天生存率。对11例PLF患者进行了研究，共进行了98次该治疗。终末期肝病模型（MELD）评分分为三个等级：20 - 29、30 - 39和40及以上。根据MELD评分的严重程度评估生存率。28天生存率为45.5%，90天生存率为27.3%。治疗后总胆红素、尿素氮和肌酐水平显著下降。另一方面，治疗后总蛋白水平升高，白蛋白水平无显著变化。从医疗经济学以及去除水溶性和与白蛋白结合的毒素方面来看，PDF可能是用于PLF病例的有用血液净化疗法。
