The Use of High Volume Plasmapheresis in Acute Liver Failure

Curēus
Landon TamEric Sy

Abstract

High volume plasmapheresis (HVP) is defined as an exchange of 8-12 L or 15% of ideal body weight with fresh-frozen plasma. It has been reported that HVP can improve outcomes in patients with acute liver failure (ALF) and/or acute-on-chronic liver failure (ACLF). Here, we present a case of a 34-year-old man presenting with ALF that led to multi-organ failure who received HVP in the intensive care unit that improved his biochemical parameters, volume status, and hemodynamics. However, despite objective clinical and biochemical improvements, the patient had developed signs of potential brain injury, and subsequently the family withdrew care. This case and the associated literature review highlight the potential value of HVP in facilities who do not have access to liver transplantation or other means of extracorporeal liver support systems.

References

Sep 20, 2008·Journal of Hepatology·Charalambos Gustav AntoniadesDiego Vergani
Feb 8, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·R Todd StravitzDon A Gabriel
Apr 8, 2014·Journal of Hepatology·Lucia A PossamaiCharalambos Gustav Antoniades
Jan 29, 2017·Journal of Critical Care·Filipe S CardosoConstantine J Karvellas
Nov 30, 2018·Seminars in Respiratory and Critical Care Medicine·Andrew J MacDonald, Constantine J Karvellas

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