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Until August 31, 2023, a comprehensive search of databases including Embase, Chinese Medical Journal Full\u2010text Database, China Biomedical Literature Database, Wan Fang Medical Network, PubMed, and the Cochrane Library was carried out using keywords like \u201cliver failure,\u201d \u201cacute\u2010on\u2010chronic liver failure,\u201d \u201cPE,\u201d \u201cDPMAS,\u201d and related terms. The quality of the included studies was evaluated using QUADS (quality assessment of diagnostic accuracy studies). Software Revman 5.3 was used to examine the data, while Stata 15.1 was used to run Egger's test. Following thorough screening, 452 patients who received PE alone and 429 patients who received DPMAS in addition to PE were included. Every study that was included was of a high caliber. When comparing the DPMAS plus PE group to the PE alone group, the total bilirubin reduction was considerably higher (mean difference [MD]\u2009=\u2009\u221249.09, 95% confidence interval [CI]: \u221254.84 to \u221243.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.00001). Prothrombin activity (PTA; MD\u2009=\u2009\u22121.53, 95% CI: \u22123.29 to \u22120.22, <jats:italic>p<\/jats:italic>\u2009=\u2009.09), albumin (ALB; MD\u2009=\u2009\u22120.58, 95% CI: \u22121.57 to 0.41, <jats:italic>p<\/jats:italic>\u2009=\u2009.25), prothrombin time (PT; MD\u2009=\u2009\u22120.07, 95% CI: \u22121.47 to 1.34, <jats:italic>p<\/jats:italic>\u2009=\u2009.92), and platelet count (PLT; MD\u2009=\u2009\u22120.08, 95% CI: \u22121.33 to 1.66, <jats:italic>p<\/jats:italic>\u2009=\u2009.90) did not differ significantly. The improvement in international standardized ratio (INR) was significantly greater in the PE group (MD\u2009=\u20090.07, 95% CI (0.03, 0.10), <jats:italic>p<\/jats:italic>\u2009=\u2009.0001). When combined with DPMAS, PE has been shown to be more effective in lowering total bilirubin levels. PE can also lower INR in individuals who have hepatitis B\u2010related ACLF. This therapeutic strategy also lessens the need for plasma transfusions.<\/jats:p>","DOI":"10.1002\/jca.22140","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T05:11:21Z","timestamp":1724735481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Comparative efficacy of double plasma molecular adsorption system combined with plasma exchange versus plasma exchange in treating acute\u2010on\u2010chronic liver failure due to hepatitis B: A meta\u2010analysis"],"prefix":"10.1002","volume":"39","author":[{"given":"Le","family":"Zhang","sequence":"first","affiliation":[{"name":"Ningxia Medical University  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Ma","sequence":"additional","affiliation":[{"name":"Ningxia Medical University  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[{"name":"Ningxia Medical University  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Na","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease General Hospital of Ningxia Medical University  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanlong","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease General Hospital of Ningxia Medical University  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2010Chun","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease General Hospital of Ningxia Medical University  Yinchuan Ningxia China"},{"name":"Infectious Disease Clinical Research Center of Ningxia  Yinchuan Ningxia China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"issue":"6","key":"e_1_2_10_2_1","first-page":"401","article-title":"Infectious Diseases Society of Chinese Medical Association, severe liver disease and artificial liver group, Hepatology Society of Chinese Medical Association. Liver failure diagnosis and guide (2018 edition)","volume":"11","author":"Liver Failure and Artificial Liver Group","year":"2018","journal-title":"Chin J Clin Infectious Dis"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314641"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1107351"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-81019-8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21690"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520932053"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i32.9614"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21799"},{"issue":"5","key":"e_1_2_10_10_1","first-page":"485","article-title":"Effects of semi\u2010plasma exchange combined with double plasma molecular adsorption system on inflammatory response, immune function and liver 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