Acute-On-Chronic Liver Failure Clinical Trial
Official title:
Platelet Transfusion in Acute-on Chronic Liver Failure
Acute on-chronic liver failure (ACLF) is a severe liver disease with a 28-day mortality rate
of up to 40%. When the patients get 3 or more organ failures, the 28-day mortality rate is up
to 82.6%. Though the ACLF patients have high short-term mortality, and the only effective
treatment method is liver transplantation. However, few patients can be treated due to the
scarcity of liver source, rapid disease progression and short transplantation window.
Our team evaluated the platelet function of 100 patients with ACLF by using the
thromboelastograghy (TEG 5000). It was found for the first time that the reactivity of
platelets of ACLF patients decreased, and the platelet inhibition rate (especially the ADP
pathway) was related to patients'short-term prognosis. When the ADP inhibition rate was 70%,
the patients'28-day mortality was up to 100%. However, the mechanism of low platelet response
to ADP in ACLF patients is still unclear. We found that the platelet function in patients
with ACLF 2-3 grade and inhibition rate beyond 70% was improved and the 28-day mortality
decreased after platelet transfusion. Whether platelet transfusion can prolong survival time
needs to be determined in a prospective controlled study. Therefore, this study is expected
to find a new therapeutic method to reduce the mortality of patients with ACLF.
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