Successful treatment of drug-induced acute liver failure with high-volume plasma exchange

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We report two patients with drug-induced liver injury (DILI)-related acute liver failure (ALF) who were successfully treated with high-volume plasma exchange without liver transplantation. The first patient was a 66-year-old man admitted because of a perforated duodenal ulcer complicated with peritonitis and septic shock. After treatment with multiple antibiotics, the patient developed DILI and ALF. Grade 3 hepatic encephalopathy and profound jaundice were present. Symptoms and signs of ALF improved dramatically after initiation of plasma exchange. The patient was discharged uneventfully. The second patient was a 94-year-old man admitted for treatment of newly diagnosed pulmonary tuberculosis. DILI and ALF developed 5 days after initiation of anti-tuberculosis treatment. Grade 4 hepatic encephalopathy was present. After plasma exchange, the patient's level of consciousness improved dramatically, and he recovered from ALF. These 2 cases show the potential of plasma exchange in the treatment of DILI despite occurrence acute liver failure. J. Clin. Apheresis, 28:430-434, 2013.

Original languageEnglish
Pages (from-to)430-434
Number of pages5
JournalJournal of Clinical Apheresis
Issue number6
Publication statusPublished - Dec 2013


  • acute liver failure
  • artificial liver support
  • drug-induced liver injury
  • plasma exchange

ASJC Scopus subject areas

  • Hematology


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