Continuous plasma exchange with dialysis in patients with acute liver failure

Abstract

Selective plasma exchange with dialysis (PED) is a type of apheresis in which simple plasma exchange is performed using a selective membrane plasma separator (Evacure EC-2A) while the dialysate flows out of hollow fibers. We developed continuous PED (cPED), which is performed in a single 48-hour session. To evaluate the effect of cPED, biochemical testing was performed in patients with acute liver failure (ALF). We examined 8 patients with ALF who received therapy (22 times in total). Creatinine levels and the international normalized ratio decreased significantly, while total protein and fibrinogen levels increased significantly after treatment. Continuous PED may be useful as blood purification therapy for removal of toxic substances and preservation of coagulation factors in patients with ALF.