Abstract
Liver failure in the context of acute (ALF) and acute on chronic liver failure (ACLF)
is associated with high mortality in the absence of a liver transplant. For decades,
therapeutic plasma exchange (TPE) is performed for the management of immune-mediated
diseases. TPE has emerged as an attractive extracorporeal blood purification technique
in patients with ALF and ACLF. The basic premise of using TPE is to remove the toxic
substances which would allow recovery of native liver functions by facilitating liver
regeneration. In recent years, encouraging data have emerged, suggesting the benefits
of TPE in patients with liver failure. TPE has emerged as an attractive liver support
device for the failing liver until liver transplantation or clinical recovery. The
data in patients with ALF suggest routine use of high-volume TPE, while the data for
such a strategy are less robust for patients with ACLF.
Keywords
SIRS - CRRT - choleric nephrosis - golden-window - MARS
