Riviello J J, Halligan G E, Dunn S P, Widzer S J, Foley C M, Breningstall G N, Grover W D
Section of Child Neurology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.
Pediatr Neurol. 1990 Nov-Dec;6(6):388-90. doi: 10.1016/0887-8994(90)90006-m.
Plasmapheresis is used for treating the complications of liver failure. We performed plasmapheresis on 6 children with hepatic encephalopathy resulting from acute hepatic failure and prospectively assessed its effects on neurologic and electrophysiologic (electroencephalography and evoked potentials) function. Clinical improvement was observed in 3 of 6 patients; changes in the serum ammonia value or the results of initial electrophysiologic tests did not predict the patient response. Two patients underwent transplantation after neurologic improvement was produced by plasmapheresis; however, despite plasmapheresis, 4 patients progressed to brain death. Our data demonstrate that plasmapheresis may transiently improve the encephalopathy of acute hepatic failure but is not curative alone. Therefore, plasmapheresis may be a useful adjunct in the treatment of liver failure, potentially improving the pretransplantation status of the patient.
