Standard Volume Plasma Exchange Is Safe and Effective For Patients With Severe Alcohol-Related Hepatitis

Background and Aim: Several patients with SAH are unsuitable for corticosteroid therapy because of kidney injury, infection, gastrointestinal bleeding. Early liver transplantation (LT) is not readily accepted in our settings. Therefore, we aimed to assess the efficacy safety Therapeutic plasma exchange (PLEX) SAH. Methods: In this prospective study, included (NIAAA definition) who were ineligible and/or unwilling LT. The primary objective was survival at days 30 90, secondary outcomes determine adverse events related PLEX predictors 30- 90-day mortality. Results: 54 (age-40.67 ± 8.04 years; males-100%; mDF score-119.75 65.72, MELD-32.08 5.43) without active infection underwent standard volume during study period. Survival one three months 76% (41/54) 57.41% (31/54), respectively.10% developed due PLEX. 22% percent patients(n=12) within weeks Patients died 3 had significantly higher severity scores baseline (MELD: 34.9 =/-5.7 vs. 30+/-4.2 alive; mDF- 152.4+/-86 95.5+/-28.1 alive patients). Baseline procalcitonin considerably (0.96+/-0.82 ng/ml) compared those survived (0.52+/-0.38:P=0.05). On multivariate logistic regression analysis, MELD NA found be a significant predictor mortality 1 month (OR, 0.72 [0.6-0.88]; P<0.001) 0.78 [0.61-0.91]; P=0.002), respectively. ROC curve MELD>=33.5, NA>=35.5, mDF>=130.8 predicted despite While MELD>=32.5, NA>=34.5, mDF>=108.5 months, indicating futility high (Figure) Conclusions: Plasma safe effective providing 57.4% months. remains best between 21-33 60-109 ideal candidates benefit from