A Multicenter Prospective Study of Application of Platelet Mapping in Acute-on-chronic-liver Failure in China

A Multicenter Prospective Study of Application of Platelet Mapping in Acute-on-chronic-liver Failure in China

Ineffective hemostasis or a paradoxical prothrombotic state of Acute-on-chronic liver disease (ACLF) has been well established. Thrombelastography measures the dynamics of thrombin production and provides a global assessment of coagulation incorporating the cumulative effect of the interactions at various levels between plasma components and cellular component of coagulation. And through the platelet mapping, it can help provide a picture of patients' function of platelet. Based on the primary result of our derivation cohort(NCT03281278), ACLF patients with high ADP inhibition rate had high 28-day mortality.This multicenter validation cohort aims to validate the predictive role of platelet mapping in ACLF prognosis, organ failure developments and short term mortality.

Inclusion Criteria:

• INR≥1.5 and total bilirubin≥85μmol/L

Exclusion Criteria:

• INR≤1.5 or total bilirubin≤85μmol/L;
• those who had hepatocellular carcinoma or other types of malignancies;
• obstructive biliary diseases or other disease lead to bilirubin evaluation;
• those who had acute hemorrhage one week before admission
• those who received platelet, cryo transfusion or plasmapheresis one week before admission
• pregnancy and breastfeeding
• those who received liver transplantation or kidney transplantation;
• combine with other disease lead to organ failure including heart failure (NYHA IV),respiratory failure（PaO2<60mmHg),renal insufficiency(CKD 5) and conscious disturbance (GCS<8)
• readmission;
• death within 24 hours.