title: Effects of plasma exchange combined with continuous renal replacement therapy on acute fatty liver of pregnancy.
abstract: BACKGROUND
  Acute fatty liver of pregnancy (AFLP) in the third trimester or early postpartum period can lead to fatal liver damage. Its traditional therapy is not very effective in facilitating hepatic recovery. The safety and effect of plasma exchange (PE) in combination with continuous renal replacement therapy (CRRT) (PE+CRRT) for AFLP still needs evaluation.
  
  
  METHODS
  Five AFLP patients with hepatic encephalopathy and renal failure were subjected to PE+CRRT in our department from 2007 to 2012. Their symptoms, physical signs and results were observed, and all relevant laboratory tests were compared before and after PE+CRRT.
  
  
  RESULTS
  All the 5 patients were well tolerated to the therapy. Four of them responded to the treatment and showed improvement in clinical symptoms/signs and laboratory results, and they were cured and discharged home after the treatment. One patient succeeded in bridging to transplantation for slowing down hepatic failure and its complications process after 2 treatment sessions. Intensive care unit stay and hospital stay were 9.4 (range 5-18) and 25.0 days (range 11-42), respectively.
  
  
  CONCLUSIONS
  PE+CRRT is safe and effective and should be used immediately at the onset of hepatic encephalopathy and/or renal failure in patients with AFLP.
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China. ljli@zju.edu.cn.
authors.forename: Cheng-Bo
authors.initials: CB
authors.lastname: Yu
authors.forename: Jia-Jia
authors.initials: JJ
authors.lastname: Chen
authors.forename: Wei-Bo
authors.initials: WB
authors.lastname: Du
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Huang
authors.forename: Yue-Mei
authors.initials: YM
authors.lastname: Chen
authors.forename: Hong-Cui
authors.initials: HC
authors.lastname: Cao
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D017583:Hemodiafiltration; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006530:Hepatorenal Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D050498:Live Birth; D010951:Plasma Exchange; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult