{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:03:47Z","timestamp":1789473827763,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Current evidence suggests that the mortality rate of intermediate\u2010stage hepatitis B virus (HBV)\u2010related acute\u2010on\u2010chronic liver failure (ACLF) remains high. We aimed to investigate the safety and efficacy of double plasma molecular adsorption system (DPMAS) with sequential low\u2010volume plasma exchange (LPE) treatment in intermediate\u2010stage HBV\u2010related ACLF. This prospective study recruited intermediate\u2010stage HBV\u2010related ACLF patients and was registered on <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link> (NCT 04597164). Eligible patients were randomly divided into a trial group and a control group. Patients in both groups received comprehensive medical treatment. Patients in the trial group further received DPMAS with sequential LPE. Data were recorded from baseline to Week 12. Fifty patients with intermediate\u2010stage HBV\u2010related ACLF were included in this study. The incidence of bleeding events and allergic reactions in the trial group was 12% and 4%, respectively, with no other treatment\u2010related adverse events. The levels of total bilirubin and prothrombin time\u2010international normalized ratio, and model for end\u2010stage liver disease scores after each session of DPMAS with sequential LPE were significantly lower than those before treatment (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The 12\u2010week cumulative liver transplantation\u2010free survival rates in the trial and control groups were 52% and 24%, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.041). The 12\u2010week cumulative overall survival rates in the trial and control groups were 64% and 36%, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.048). The Kaplan\u2013Meier survival analysis revealed significant differences in liver transplantation\u2010free survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.047) and overall survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.038) between the trial and control groups. Cox regression analysis indicated that blood urea nitrogen (<jats:italic>p<\/jats:italic>\u2009=\u20090.038), DPMAS with sequential LPE (<jats:italic>p<\/jats:italic>\u2009=\u20090.048), and Chinese Group on the Study of Severe Hepatitis B\u2010ACLF II score (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were significant risk factors for mortality. DPMAS with sequential LPE treatment is safe and effective for patients with intermediate\u2010stage HBV\u2010related ACLF.<\/jats:p>","DOI":"10.1002\/jmv.28650","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T13:10:22Z","timestamp":1678453822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Safety and efficacy of double plasma molecular adsorption system with sequential low\u2010volume plasma exchange in intermediate\u2010stage hepatitis B virus\u2010related acute\u2010on\u2010chronic liver failure"],"prefix":"10.1002","volume":"95","author":[{"given":"Wenxiong","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeqiong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhexuan","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiumin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6184-5750","authenticated-orcid":false,"given":"Liang","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"},{"name":"Guangdong Key Laboratory of Liver Disease Research The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization. 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