Role of therapeutic plasmapheresis in acute liver failure in paediatric patients: a case series Authors Ayaz Ur Rehman Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Wajiha Khan Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Salman Khan Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Awais Abbas Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Qalab Abbas Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Naveed Ur Rehman Siddiqui Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan DOI: https://doi.org/10.47391/JPMA.10331 Keywords: Acute liver failure, Plasmapheresis, Plasma exchange, Hepatitis Abstract Paediatric acute liver failure (PALF) is a rare yet severe condition that is associated with high mortality. Apart from liver transplant, no specific therapy exists, particularly in developing countries. Evidence suggests that removal of damage-associated molecular patterns, cytokines, toxins, and other metabolites that accumulate due to impaired liver function can enhance natural recovery. Plasmapheresis can be used to remove these products; however, there is limited evidence to support this approach. This case series discusses three critically ill patients with acute liver failure who underwent plasmapheresis. The patients included a seven-year-old boy (Case 1), a 17-year-old boy (Case 2), and a 16-month-old boy (Case 3). Two patients showed significant improvement in bilirubin level, coagulation profile, inotropes requirement, and Glasgow coma scale score. Unfortunately, one patient with PALF, complicated with multi-organ dysfunction, died due to refractory shock on the fourth day of hospitalisation. ---Continue Author Biographies Ayaz Ur Rehman, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Resident Department of Pediatric Child and Health Wajiha Khan, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Resident Department of Pediatric Child and Health Salman Khan, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Resident Department of Pediatric child and Health Awais Abbas, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Senior Instructor Department of Pediatric Critical care medicine, Aga Khan University hospital Karachi Qalab Abbas, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Associate Professor Department of Pediatric Critical Care medicine, Aga Khan University hospital Karachi Naveed Ur Rehman Siddiqui, Department of Paediatric Child and Health, Aga Khan University Hospital, Karachi, Pakistan Assistant Professor Department of Pediatric Critical medicine, Aga Khan University hospital Karachi Downloads Full Text Article Published 2024-08-23 How to Cite Ayaz Ur Rehman, Khan, W., Khan, S., Awais Abbas, Qalab Abbas, & Naveed Ur Rehman Siddiqui. (2024). Role of therapeutic plasmapheresis in acute liver failure in paediatric patients: a case series. Journal of the Pakistan Medical Association, 74(9), 1707–1710. https://doi.org/10.47391/JPMA.10331 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 74 No. 9 (2024): SEPTEMBER Section Case Series License Copyright (c) 2024 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.