Brar Harsimran S, Dadlani Apaar, Ng Alex M
Internal Medicine, University of Louisville, Louisville, USA.
Pulmonary and Critical Care, University of Louisville, Louisville, USA.
Cureus. 2021 Jul 3;13(7):e16143. doi: 10.7759/cureus.16143. eCollection 2021 Jul.
Acute liver failure carries a high mortality. At present, liver transplant is the definitive treatment along with standard medical support. In the absence of or as a bridge to liver transplant, several liver assist therapies have been derived. Some of the therapies have shown short-term mortality benefits and transplant-free survival over standard medical treatment alone. High volume plasmapheresis (HVP) is one of such therapies and is readily available in hospitals. We discuss the case of a 28-year-old female who presented with acute liver failure, did not qualify for the liver transplant and successfully underwent HVP. Various regimens of plasmapheresis have been described in the literature of which we used the HVP for pre-determined three days. Our case emphasizes the importance of early initiation of HVP in an acute liver failure patient who did not qualify for liver transplant, and adds to the existing evidence of the utility of this particular type of plasmapheresis over other regimens.
急性肝衰竭死亡率很高。目前，肝移植是 definitive 治疗方法，同时辅以标准的医学支持。在没有肝移植或作为肝移植桥梁的情况下，已经衍生出几种肝辅助治疗方法。其中一些治疗方法已显示出相对于单独的标准医学治疗具有短期死亡率益处和无移植生存期。大容量血浆置换术（HVP）就是这样一种治疗方法，在医院中很容易获得。我们讨论了一名28岁女性的病例，该女性患有急性肝衰竭，不符合肝移植条件，但成功接受了HVP治疗。文献中描述了各种血浆置换方案，我们使用HVP进行了预定的三天治疗。我们的病例强调了在不符合肝移植条件的急性肝衰竭患者中早期开始HVP的重要性，并补充了这种特定类型的血浆置换术相对于其他方案实用性的现有证据。
