Early plasma exchange for progressive liver failure in recipients of adult-to-adult living-related liver transplants.
OBJECTIVE
Little information is available concerning the effectiveness of plasma exchange for progressive liver failure in liver transplant recipients. The aims of the present study were to evaluate the effectiveness of plasma exchange and discuss its indication.


METHODS
Forty-six ABO-compatible recipients of living-related liver transplants operated on in Osaka University hospital were retrospectively studied.


RESULTS
Total bilirubin was identified as the most accurate predictor of the short-term prognosis of 46 recipients (optimal cut-off point: 13.3 mg/dl). Eleven patients received 14 plasma exchange sessions. Elevation of total bilirubin was significantly suppressed after plasma exchange in the patients with total bilirubin below the median (24 mg/dl), whereas total bilirubin significantly increased even after plasma exchange in those with total bilirubin above the median.


CONCLUSIONS
Plasma exchange improved liver function in recipients with progressive liver failure and appears to be indicated in patients with total bilirubin levels ranging between 13 and 24 mg/dl.
Yamamoto
Ryohei
R
Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
Nagasawa
Yasuyuki
Y
Marubashi
Shigeru
S
Furumatsu
Yoshiyuki
Y
Iwatani
Hirotsugu
H
Iio
Kenichiro
K
Matsui
Isao
I
Dono
Keizo
K
Imai
Enyu
E
Monden
Morito
M
Isaka
Yoshitaka
Y