Abstract: Objective To evaluate the efficacy and safety of combination therapy of bilirubin adsorption and plasma exchange (PE) on patients with liver failure,and try to establish a new combination therapy modality. Methods The first group of 35 patients with liver failure were treated with plasma exchange (PE) and plasma bilirubin absorpsion (PBA),and the second group of 35 patients with liver failure were treated with simple plasmapheresis.The levels of TBIL(total bilirubin),AST(alanine aminotransferase) and ALB(albumin) were measured and compared before and after treatment.And plasma dosage and primary side effects(such as fever,rash,skin itching) were also compared between the two groups. Results ①The serum levels of TBIL and DBIL of the patients in both groups after treatment were significantly lower than those before treatment,with significant difference(P<0.05);and the decreased levels of TBIL and DBIL in the combination group were significantly higher than those in the second group(P<0.05).②The ALB levels in the patients of both groups after treatment were significant higher than those before treatment(P<0.05).③Plasma dosages in the combined group were lower than those in the second group(P<0.05).④The incidences of the side effects including fever,rash and anaphylactic shock in the two groups were about 15%,10%,0% and 40%,50%,15% respectively.There was a statistical difference between the incidences of any two of the three side effects(P<0.05). Conclusion The combination therapy of plasma exchange and bilirubin adsorption is effective in the treatment of liver failure,which is significant in reducing TBIL level,DBIL level,plasma dosage, and the incidences of side effects.

Key words: Plasma exchange, Bilirubin adsorption, Liver failure, Clinical research