Abstract: Objective To assess the safety and efficacy of citrate to heparin as a catheter locking solution in patients with liver failure undergoing artificial liver support system (ALSS) therapy. Methods 41 patients with acute-on-chronic liver failure were recruited in our hospital, and all the patients received double plasma molecular absorption system (DPMAS)and sequential plasma exchange (PE). The citrate or heparin was used as locking catheter solution in 22 patients with 80 times and in 19 patients with 79 times, respectively. Blood activated partial thromboplastin time (APTT) were monitored. Results Two hours after locking, the blood APTT in citrate-locking was (65.6±12.2)s, significantly shorter than【(89.8±43.1)s,P<0.01】 in heparin-locking; the incidences of catheter-related infection in the two groups was 0.0%(0/22) and 5.3%(1/19), respectively, without significant difference (P=0.46); there were no significant differences as respect to the 3-month survival (52.3% vs. 54.5%), hospital stay, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatic-renal syndrome and gastrointestinal bleeding in the two groups (P>0.05). Conclusions The application of citrate for catheter locking has a good approach in patients with liver failure undergoing ALSS therapy, without obvious alteration of coagulation index, which might be safer.

Key words: Liver failure, Artificial liver support system therapy, Citrate, Lock solution