High-Volume Plasma Exchange Versus Standard Medical Treatment in Patients With Acute Liver Failure

High-Volume Plasma Exchange Versus Standard Medical Treatment in Patients With Acute Liver Failure-A Prospective Randomized Pilot Trial

The study will be conducted on patients admitted to Department of Hepatology from Jan 2016 to Jan 2018 at Institute of Liver & Biliary Sciences, New Delhi. Study group will comprise of patients with acute liver failure (ALF) who have no option for liver transplant (due to any reason) or have contraindications for liver transplant or have no prospective living donor and will be assessed for enrollment in the trial.

Inclusion Criteria:

• Patients with acute liver failure defined as : Patients with jaundice which is complicated by encephalopathy and coagulopathy within 4 weeks of the onset of jaundice and without underlying chronic liver disease.

Exclusion Criteria:

• Age <12 or > 75 years
• Hepato-Cellular Carcinoma
• Active untreated Sepsis/DIC
• Any evidence of active bleed secondary to coagulopathy
• Hemodynamic instability requiring high dose of Vasopressors
• Coma of non-hepatic origin.
• Pregnancy
• Comorbidities associated with poor outcome (Extrahepatic neoplasia, severe cardiopulmonary disease defined by a New York Heart Association score >3, or oxygen/steroid-dependent chronic obstructive pulmonary disease).
• Patients being taken up for liver transplant
• Refusal to participate in the study.