{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:39:12Z","timestamp":1792172352654,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to evaluate the safety and efficacy of therapeutic plasma exchange (TPE) in pediatric acute liver failure (PALF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All children aged 2\u201018\u2009years with PALF were included. The intervention cohort included a subset of PALF patients undergoing complete three sessions of TPE, whereas the matching controls were derived by propensity score matching from the patient cohort who did not receive any TPE. Propensity matching was performed based on the international normalized ratio (INR), grade of hepatic encephalopathy (HE), age, bilirubin, and ammonia levels. The primary outcome measure was native liver survival (NLS) in the two arms on day 28.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the total cohort of 403 patients with PALF, 65 patients who received TPE and 65 propensity\u2010matched controls were included in analysis. The 2 groups were well balanced with comparable baseline parameters. On day 4, patients in the TPE group had significantly lower INR (<jats:italic>P<\/jats:italic>\u2009=\u20090.001), lower bilirubin (<jats:italic>P<\/jats:italic>\u2009=\u20090.008), and higher mean arterial pressure (MAP) (<jats:italic>P<\/jats:italic>\u2009=\u20090.033) than controls. The NLS was 46.15% in the TPE arm and 26.15% in the control arm. The overall survival (OS) was 50.8% in the TPE arm and 35.4% in the control arm. Kaplan\u2010Meier survival analysis showed a significantly higher NLS in patients receiving TPE than controls (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). On subgroup analysis, NLS benefit was predominantly seen in hepatitis A\u2010related and indeterminate PALF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TPE improved NLS and OS in a propensity\u2010matched cohort of patients with PALF. Patients receiving TPE had lower INR and bilirubin levels and higher MAP on day 4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.22130","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:39:02Z","timestamp":1718361542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Therapeutic plasma exchange provides native liver survival benefit in children with acute liver failure: A propensity score\u2010matched analysis"],"prefix":"10.1002","volume":"39","author":[{"given":"Tamoghna","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6275-7736","authenticated-orcid":false,"given":"Bikrant Bihari","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology 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