NOW HELPFUL IS PLASMAPHERESIS IN THE MANAGEMENT OF ACUTE LIVER FAILURE IN ADULTS

Objective: To compare the efficacy of plasmapheresis against other modalities of management in patients of acute liver failure Study Type: Cross-sectional Study Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from June 2023 to July 2024 Methodology: Patients of either sex between 18 years to 75 years of age meeting the acute liver failure criteria were enrolled into the study. Patients with liver failure due to pre-exiting liver disease, septicaemia, and heart failure were excluded from the study. The detailed history and clinical information were taken from all individuals after enrolment. The blood sample for serum alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, prothrombin time, international normalised ratio, bilirubin, and creatinine were taken pre- and post- plasmapheresis sessions. The plasmapheresis was done until clinical improvement was achieved. The data was analysed using the Statistical Package for Social Sciences (SPSS) Version 25.0. Results:A total of one hundred and seventy-six (n=176) were included in this study with median age of 47.00 (36.00-57.00) years. There were 53 (30.11%) females and 123 (69.89%) males. The median pre-plasmapheresis serum ALT was 602.00 (455.00-764.00) while post-plasmapheresis it was 324.00 (192.00-463.00). The median pre-plasmapheresis serum bilirubin was 34.00 (25.00-43.00) while post-plasmapheresis it was29.00 (21.00-39.00). The international normalised ratio was 24.00 (21.00-26.00) and 19.00 (15.00-20.00) pre and post plasmapheresis session. The improvement in liver markers was statistically significant (p<0.001) post plasmapheresis. Conclusion:The plasmapheresis sessions were very effective in improving the outcome in patients of acute liver failure.