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.

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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

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

Issue

Section

Case Series

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