High-Volume Plasma Exchange Versus Standard Medical Treatment in Patients With Acute Liver Failure
Acute Liver Failure
About this trial
This is an interventional treatment trial for Acute Liver Failure
Eligibility Criteria
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.
Sites / Locations
- Institute of liver and Biliary Sciences
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Standard medical therapy with Plasma Exchange
Standard medical therapy alone
Plasma Exchange will be performed for consecutive days. Standard medical therapy included as per requirement,management of cerebral edema/intracranial hypertension: transfer to ICU,prophylactic antibiotics, intubation of trachea (as required),administration of mannitol or 3% saline for severe elevation of Intra Cranial Pressure,volume replacement and pressor support (norepinephrine, vasopressin) as needed, NAC, correction of metabolic parameters and nutrition.
Standard medical therapy included as per requirement,management of cerebral edema/intracranial hypertension: transfer to ICU,prophylactic antibiotics, intubation of trachea (as required),administration of mannitol or 3% saline for severe elevation of Intra Cranial Pressure,volume replacement and pressor support (norepinephrine, vasopressin) as needed, NAC, correction of metabolic parameters and nutrition.