High-volume plasma exchange in a patient with acute liver failure due to non-exertional heat stroke in a sauna

2014 ◽  
Vol 29 (5) ◽  
pp. 281-283 ◽  
Author(s):  
Kuan-Jung Chen ◽  
Tso-Hsiao Chen ◽  
Yuh-Mou Sue ◽  
Tzay-Jinn Chen ◽  
Chung-Yi Cheng
2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bertram K. Woitok ◽  
Shawki Bahmad ◽  
Gregor Lindner

Background.Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10  km run in 28°C outside temperature who developed acute liver failure. Case Presentation. Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care. Conclusions. Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.


2019 ◽  
Vol 28 (3) ◽  
pp. 364-364
Author(s):  
Dimitrios S. Politis ◽  
Gerasimos Baltagiannis ◽  
Nikolaos Tzampouras ◽  
George N Kalambokis ◽  
Vasileios Koulouras ◽  
...  

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Author(s):  
Emma C. Alexander ◽  
Akash Deep

AbstractPaediatric acute liver failure (PALF) is a rare but devastating condition with high mortality. An exaggerated inflammatory response is now recognised as pivotal in the pathogenesis and prognosis of ALF, with cytokine spill from the liver to systemic circulation implicated in development of multi-organ failure associated with ALF. With advances in medical management, especially critical care, there is an increasing trend towards spontaneous liver regeneration, averting the need for emergency liver transplantation or providing stability to the patient awaiting a graft. Hence, research is ongoing for therapies, including extracorporeal liver support devices, that can bridge patients to transplant or spontaneous liver recovery. Considering the immune-related pathogenesis and inflammatory phenotype of ALF, plasma exchange serves as an ideal liver assist device as it performs both the excretory and synthetic functions of the liver and, in addition, works as an immunomodulatory therapy by suppressing the early innate immune response in ALF. After a recent randomised controlled trial in adults demonstrated a beneficial effect of high-volume plasma exchange on clinical outcomes, this therapy was incorporated in European Association for the Study of Liver (EASL) recommendations for managing adult patients with ALF, but no guidelines exist for PALF. In this review, we discuss rationale, timing, practicalities, and existing evidence regarding the use of plasma exchange as an immunomodulatory treatment in PALF. We discuss controversies in delivery of this therapy as an extracorporeal device, and practicalities of use of plasma exchange as a ‘hybrid’ therapy alongside other extracorporeal liver assist devices, before finally reviewing outstanding research questions for the future.


2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1277
Author(s):  
Lindsay Clarke ◽  
Daniel Szvarca ◽  
Danielle Davison ◽  
Bedoor Alabbas ◽  
Marie Borum

2016 ◽  
Vol 63 (4) ◽  
pp. e75-e76 ◽  
Author(s):  
Jacob A. Kurowski ◽  
Henry C. Lin ◽  
Saeed Mohammad ◽  
Steven Krug ◽  
Estella M. Alonso

Author(s):  
A. Tharwani ◽  
A. Bhardwaj ◽  
M. Aggarwal ◽  
H. Einchenlaub ◽  
K. Kommaraju ◽  
...  

2015 ◽  
Vol 14 (1) ◽  
pp. 49-50 ◽  
Author(s):  
Cécile Salathé ◽  
Cyril Pellaton ◽  
Pierre-Nicolas Carron ◽  
Marcos Coronado ◽  
Lucas Liaudet

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