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Safety of High-Volume Plasmapheresis in Children With Acute Liver Failure
- Source :
- Journal of Pediatric Gastroenterology & Nutrition. 72:815-819
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- OBJECTIVES Paediatric acute liver failure (P-ALF) is a rare condition and is associated with a high mortality rate. Management of P-ALF aims to stabilise vital organ functions and to remove circulating toxins and provide vital plasma factors that are lacking. High-volume plasmapheresis (HVP) removes protein-bound substances and improves survival in adult ALF. It is unknown if this effect can be extrapolated to P-ALF. The aim of this study is to report the safety and feasibility of HVP in P-ALF. METHODS Children with P-ALF were offered HVP if bilirubin was higher than 200 μmol/L or if the aetiology was toxic hepatitis. HVP was performed with fresh frozen plasma corresponding to 10% of the body weight on a minimum of 3 consecutive days. Diagnostics, biochemical and clinical data during HVP as well as outcome data after 3 months were collected from 2012 to 2019 and retrospectively analysed. RESULTS Sixteen children were treated by HVP and completed at least one series of three treatment sessions with HVP. The only complication seen was an increase in pH > 7.55 in three children within the first 12 hours and was corrected with hydrochloric acid. No bleeding or septic episodes were noted during HVP. Eight children survived without liver transplantation, two survived after successful grafting and a total of six children died. The liver injury unit score between survivors with their own liver and the rest, the two groups was significantly different (P = 0.005). CONCLUSION HVP with fresh frozen plasma is feasible and well tolerated in children with P-ALF. No serious adverse events and no procedure-related mortality were observed.
- Subjects :
- Adult
Toxic hepatitis
medicine.medical_specialty
medicine.medical_treatment
Liver transplantation
Gastroenterology
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
medicine
Humans
Child
Adverse effect
Retrospective Studies
Liver injury
business.industry
Mortality rate
digestive, oral, and skin physiology
Plasmapheresis
Liver Failure, Acute
medicine.disease
Liver Transplantation
Pediatrics, Perinatology and Child Health
030211 gastroenterology & hepatology
Fresh frozen plasma
Chemical and Drug Induced Liver Injury
medicine.symptom
Complication
business
Subjects
Details
- ISSN :
- 15364801 and 02772116
- Volume :
- 72
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Gastroenterology & Nutrition
- Accession number :
- edsair.doi.dedup.....8a464eb55c98a8024bb52a0157feba1e