Abstract: Objective To investigate the influence of plasma exchange on prognostic factors of patients with hepatitis B associated chronic acute liver failure（HBV-ACLF）awaiting liver transplantation. Methods A retrospective analysis was performed on patients with HBV-ACLF who received PE while waiting for liver transplantation in Shanghai Changzheng Hospital from June 2018 to June 2021,including the basic information（gender,age,blood type）of the patients,number and dosage of PE,changes of indicators before and after PE,adverse reactions related to PE and the prognosis of the patients. Results Fifty-one cases were included in this research. Multivariate analysis showed that blood ammonia（BA）difference before and after PE was an independent risk factor for 90 days and long-term outcomes in HBV-ACLF patients awaiting liver transplantation treated with PE,and platelet count before PE was also an independent risk factor for long-term outcomes in these patients. ROC curve calculation showed that after PE reduction of BA to 4% of that before PE might result in a better prognosis. Conclusion The change range of BA before and after PE is an effective indicator to predict the efficacy of PE and the prognosis of HBV-ACLF patients,which has guiding significance for the rational allocation and usage of plasma resources.

Key words: Plasma exchange, Artificial liver treatment, Hepatitis B, Acute-on-chronic liver failure, Dynamic blood ammonia