Efficacy of continuous plasma diafiltration therapy in critical patients with acute liver failure

Background and Aims Acute liver failure (ALF) is a critical illness with high mortality. Plasma diafiltration (PDF) is a blood purification therapy that is useful for ALF patients, but it is difficult to use when those patients have multiple organ failure or unstable hemodynamics. In these patients, symptoms are also likely to exacerbate immediately after PDF therapy. We developed continuous PDF (CPDF) as a new concept in PDF therapy, and assessed its efficacy and safety in ALF patients. Methods Ten ALF patients (gender: M/F 6/4, Age: 47 ± 14) were employed CPDF therapy. The primary outcomes were altered liver function, measured by the model for end‐stage liver disease (MELD) score, and total bilirubin and prothrombin time international normalized ratios (PT‐INR), 5 days after CPDF therapy. Secondary outcomes included sequential organ failure assessment (SOFA) scores, 5 days after CPDF therapy, and the survival rate 14 days after this therapy. Results The MELD score (34.5–28.0; P = 0.005), total bilirubin (10.9–7.25 mg/dL; P = 0.048), PT‐INR (1.89–1.31; P = 0.084), and SOFA score (10.0–7.5; P