Association between longer duration of citrate accumulation and 90-day mortality of acute-on-chronic liver failure

Regional citrate anticoagulation (RCA) is an optional anticoagulant for plasma adsorption (PA) plus plasma exchange (PE) therapy in patients with acute-on-chronic liver failure (ACLF), but with risk of transient citrate accumulation due to plasma and citrate [1]. [...]no significant differences in 90-day mortality risk were observed with the Cox proportional hazards models established with LDCA, age, gender, liver cirrhosis, HBV DNA, other co-existing liver diseases, comorbidities, and disease severity (Model 1, COSSH ACLF score; Model 2, CLIF-C ACLF score; Model 3, AARC ACLF score; Model 4, MELD score): Model 1 adjusted HR (95% CI), 1.07 (0.66–1.73); Model 2, 1.49 (0.95–2.36); Model 3, 1.41 (0.90–2.22); Model 4, 1.05 (0.65–1.72) (Table 2). Safety and efficacy of regional citrate anticoagulation during plasma adsorption plus plasma exchange therapy for patients with acute-on-chronic liver failure: a pilot study.