Liver Disease



  • Apheresis is one of the possible therapeutic strategies for acute liver failure, such as that caused by fulminant hepatitis and post-surgery liver failure.

  • Plasma exchange (PE) plays an important role as an artificial liver support (ALS) until progressive hepatocyte necrosis ends and sufficient hepatic regeneration occurs.

  • Liver transplantation has recently improved the prognosis of fulminant hepatitis. Preoperative conditions, especially hepatic coma, are known to have a great impact on the survival rates associated with liver transplantation. Therefore, apheresis in liver failure is necessary as a bridge therapy to transplantation.


Liver Failure Plasma Exchange Acute Liver Failure Fulminant Hepatitis Total Bilirubin Level 


  1. 1.
    Yoshiba M, Sekiyama K, Inoue K, Yamada M, Kako M, Nagai K, Takatori M, Iwabuchi S, Sumino Y, Tanaka K, Hakozaki Y, Hasegawa K, Shibuya A (2002) Accurate prediction of fulminant hepatic failure in severe acute viral hepatitis: multicenter study. J Gastroenterol 37:916–21PubMedCrossRefGoogle Scholar
  2. 2.
    Yoshiba M, Sekiyama K, Iwamura Y, Sugata F (1993) Development of reliable artificial liver support (ALS)–plasma exchange in combination with hemodiafiltration using high-performance membranes. Dig Dis Sci 38:469–76PubMedCrossRefGoogle Scholar
  3. 3.
    Takikawa Y, Suzuki K (2008) Clinical epidemiology of fulminant hepatitis in Japan. Hepatol Res 38:S14–S18PubMedCrossRefGoogle Scholar
  4. 4.
    Sadahiro T, Hirasawa H, Oda S, Shiga H, Nakanishi K, Kitamura N, Hirano T (2001) Usefulness of plasma exchange plus continuous hemodiafiltration to reduce adverse effects associated with plasma exchange in patients with acute liver failure. Crit Care Med 29:1386–92PubMedCrossRefGoogle Scholar
  5. 5.
    Boyle M, Kurtovic J, Bihari D, Riordan S, Steiner C (2004) Equipment review: the molecular adsorbents recirculating system (MARS). Crit Care 8:280–6PubMedCrossRefGoogle Scholar
  6. 6.
    Falkenhagen D, Strobl W, Vogt G, Schrefl A, Linsberger I, Gerner FJ, Schoenhofen M (1999) Fractionated plasma separation and adsorption system: a novel system for blood purification to remove albumin bound substances. Artif Organs 23:81–6PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  1. 1.Department of Emergency and Critical Care MedicineUniversity Hospital, The University of TokyoTokyoJapan

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