The Study On The Hepatic Functional Reserve Affected By The Treatment Of Artificial Liver Support System In Patients Of Liver Failure

Objective:To evaluate the hepatic functional reserve of hepatic failure, and the effect of artificial liver support system (ALSS) with the index of Indocyanine Green 15 minutes retention rate (ICGR15)Material and methods:83 cases of hepatic failure, were detected with Indocyanine Green (ICG) and effective hepatic blood flow (EHBF) by pulse dye densito graphanalyzer (PDDG) before and after the therapy of plasma exchange (PE). Then cases of the cured were fallen under the effect group, while others were no effect group.Results:1) The cure rates of early and middle period of Subacute hepatic, failure (SALF) group were 100%(9/9) and 71.4% (5/7) respectively. No significance in statistics was found (P>0.05). While the rates of good trend for acute-on-chronic liver failure (ACLF) were 93.8%(15/16),55.8%(24/43) and 0%(0/6) in early, middle and late periods, respectively. The rate in early period was better than the one in mid period, and the rate in mid period was better than the one in the late period (P<0.05).There was no significance in statistics was found between the SALF group and ACLF group in the early and middle period (P>0.05).2)The R15 and EHBF of valid group and invalid group before ALSS were 48.333±11.482 vs 54.817±6.514 (t=2.229, P＜0.05), and 240.29±84.007 vs 189.62±58.572 (t=2.872, P＜0.05) Significance in statistics was found. The AUC of R15 for the short-term prediction of prognosis was 0.712. The optimal critical value was 50.95% with the corresponding sensitivity 59.3% and specificity 79.3%.3) The R15 of valid group before and after ALSS were 48.333±11.482 vs 52.261±0.666(t=2.229, P＜0.05). The EHBF were 240.29±84.007vs202.04±64.616(t=3.979, P<0.05).The R15 of invalid group were 54.817±6.514 vs 66.328±7.684 (t=6.018, P＜0.05). The EHBF were 189.62±58.572vs 129.52±44.486 (t=6.404, P＜0.05). Significance in statistics was found.Conclusions:There is consanguineous relationships between the curative effect and the cure time. We can estimate the state of the illness through the check of hepatic functional reserve for liver failure patients. The R15 value is positive relationship with the state of disease, and negtive relationship with the EHBF in liver. R15 value can estimate the prognosis of liver failure with the moderate power. The R15 value before ALSS is higher than the one after ALSS, while the EHBF value is on the contrary.