The effect of total plasma exchange on fulminant hepatic failure

M. Akdogan, C. Camci, A. Gurakar, R. Gilcher, S. Alamian, H. Wright, Bakr Nour, A. Sebastian

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Total plasma exchange (TPE) corrects coagulopathy in patients with liver disease and removes hepatotoxins/cytokines. This improvement is transient but can be used as a bridge until an organ is identified for liver transplantation (LTx) or the liver itself regenerates. Our aim was to retrospectively assess the efficacy of TPE in fulminant hepatic failure (FHF) and its impact on liver function tests. Between 1995 - 2001, 39 patients with FHF who had undergone TPE were reviewed. FHF was defined according to the O'Grady criteria based on the duration of encephalopathy as well as jaundice. TPE was performed using the Cobe Spectra TPE (Gambro) in Liver Intensive Care Unit, continued on a daily basis, until either adequate clinical response was achieved, the patient expired, or transplantation occurred. INR, PTT, Fibrinogen, ALT, AST, GGT, BUN, Ammonia, and Total Bilirubin were analyzed before and after TPE. Student's t-test and chi-square test and ANOVA were used for statistical analysis. Thirty-nine patients with FHF (31 females, 8 males with mean age of 32.3, range: 7 - 64) underwent TPE. Coagulopathy, hyperbilirubinemia, hyperammonemia were significantly improved (P < 0.05). Twenty-one patients survived (54%), 12 required LTx, and 18 patients (including one after LTx) expired. TPE was found to be significantly effective for correction of coagulopathy and improvement of liver tests. This intervention can be considered for temporary liver support until recovery or liver transplantation.

Original languageEnglish
Pages (from-to)96-99
Number of pages4
JournalJournal of Clinical Apheresis
Volume21
Issue number2
DOIs
Publication statusPublished - Jul 2006
Externally publishedYes

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Plasma Exchange
Acute Liver Failure
Liver
Liver Transplantation
Hyperammonemia
Hyperbilirubinemia
International Normalized Ratio
Liver Function Tests
Blood Urea Nitrogen
Brain Diseases
Chi-Square Distribution
Jaundice
Bilirubin
Ammonia
Fibrinogen
Intensive Care Units
Liver Diseases
Analysis of Variance
Transplantation
Cytokines

ASJC Scopus subject areas

  • Hematology

Cite this

Akdogan, M., Camci, C., Gurakar, A., Gilcher, R., Alamian, S., Wright, H., ... Sebastian, A. (2006). The effect of total plasma exchange on fulminant hepatic failure. Journal of Clinical Apheresis, 21(2), 96-99. https://doi.org/10.1002/jca.20064

The effect of total plasma exchange on fulminant hepatic failure. / Akdogan, M.; Camci, C.; Gurakar, A.; Gilcher, R.; Alamian, S.; Wright, H.; Nour, Bakr; Sebastian, A.

In: Journal of Clinical Apheresis, Vol. 21, No. 2, 07.2006, p. 96-99.

Research output: Contribution to journalArticle

Akdogan, M, Camci, C, Gurakar, A, Gilcher, R, Alamian, S, Wright, H, Nour, B & Sebastian, A 2006, 'The effect of total plasma exchange on fulminant hepatic failure', Journal of Clinical Apheresis, vol. 21, no. 2, pp. 96-99. https://doi.org/10.1002/jca.20064
Akdogan M, Camci C, Gurakar A, Gilcher R, Alamian S, Wright H et al. The effect of total plasma exchange on fulminant hepatic failure. Journal of Clinical Apheresis. 2006 Jul;21(2):96-99. https://doi.org/10.1002/jca.20064
Akdogan, M. ; Camci, C. ; Gurakar, A. ; Gilcher, R. ; Alamian, S. ; Wright, H. ; Nour, Bakr ; Sebastian, A. / The effect of total plasma exchange on fulminant hepatic failure. In: Journal of Clinical Apheresis. 2006 ; Vol. 21, No. 2. pp. 96-99.
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