{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:17:41Z","timestamp":1783354661685,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multi\u2010organ dysfunction in acute liver failure (ALF) has been attributed to a systemic inflammatory response directly triggered by the injured liver. High\u2010volume therapeutic plasma exchange (HV\u2010TPE) has been demonstrated in a large randomized controlled trial to improve survival. Here, we investigated if a more cost\u2010\/ resource effective low\u2010volume (LV) TPE strategy might have comparable beneficial effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study evaluated the effect of LV\u2010TPE on remote organ failure, hemodynamical and biochemical parameters as well as on survival in patients with ALF. Twenty patients treated with LV\u2010TPE in addition to standard medical therapy (SMT) were identified and 1:1 matched to a historical ALF cohort treated with SMT only. Clinical and biochemical parameters were recorded at admission to the intensive care unit and the following 7 days after LV\u2010TPE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean arterial pressure increased following first LV\u2010TPE treatments (d0: 68 [61\u201075] mm\u2009Hg vs d7: 88 [79\u201098] mm\u2009Hg, <jats:italic>P<\/jats:italic> = .003) and norepinephrine dose was reduced (d0: 0.264 [0.051\u20100.906] \u03bcg\/kg\/min vs d3: 0 [0\u20100.024] \u03bcg\/kg\/min, <jats:italic>P<\/jats:italic> = .016). Multi\u2010organ dysfunction was significantly diminished following LV\u2010TPE (CLIF\u2010SOFA d0: 17 [13\u201020] vs d7: 7 [3\u201011], <jats:italic>P<\/jats:italic> = .001). Thirty\u2010day in\u2010hospital survival was 65% in the LV\u2010TPE cohort and 50% in the SMT cohort (Hazard\u2010ratio for TPE: 0.637; 95% CI: 0.238\u20101.706, <jats:italic>P<\/jats:italic> = .369).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients treated with LV\u2010TPE showed improved surrogate parameters comparable with the effects reported with HV\u2010TPE. These data need to be interpreted with caution due to their retrospective character. Future controlled studies are highly desirable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21737","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T13:19:33Z","timestamp":1564147173000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Therapeutic plasma exchange in acute liver failure"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4833-6035","authenticated-orcid":false,"given":"Klaus","family":"Stahl","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Hadem","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Manns","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Wiesner","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and German Centre of Lung Research (DZL) Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard M. W.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius M.","family":"Hoeper","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and German Centre of Lung Research (DZL) Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"David","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208937"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26307"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(03)01051-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2000.17687"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2008.08.009"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03706.x"},{"key":"e_1_2_9_8_1","first-page":"887","article-title":"Systemic vascular resistance during high\u2010volume plasmapheresis in patients with fulminant hepatic failure: relationship with oxygen consumption","volume":"7","author":"Larsen FS","year":"1995","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199603000-00014"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.08.018"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139889201501110"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2220-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21470_c"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.12.003"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.06.012"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.12.039"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(17)30279-9"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.025"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.05.033"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.02.016"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21737","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.21737","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.21737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T20:20:16Z","timestamp":1694290816000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.21737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,26]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1002\/jca.21737"],"URL":"https:\/\/doi.org\/10.1002\/jca.21737","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,26]]},"assertion":[{"value":"2019-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}