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Management of acute liver failure during pregnancy by therapeutic plasma exchange - A multidisciplinary approach

Rishabh Bose1, Aswin K Mohan2, Vaidehi Prasanth2

  • 1Department of Gastroenterology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Asian Journal of Transfusion Science
|August 21, 2025
PubMed

Therapeutic plasma exchange (TPE) has been associated to improve survival in critically ill patients with liver failure who are not anticipated to survive until liver transplantation. In pregnant patients with acute liver failure (ALF), standard volume TPE can be done, foreseeing complications such as fetal distress, hypofibrinogenemia, hypercalcemia, and adverse transfusion reactions. TPE has been demonstrated to lower inflammatory cytokine levels, modify adaptive immunity with the potential to minimize infection susceptibility, and lower albumin and water-bound toxin levels in liver failure. In this article, the multidisciplinary approach, efficacy, and technical considerations were elaborated in the management of a young pregnant female diagnosed with ALF by TPE.

Keywords:
Acute liver failurecytokinesmultidisciplinary approachprecautions in pregnancytherapeutic plasma exchange in pregnancy

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