{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:48:39Z","timestamp":1782460119931,"version":"3.54.5"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Acute liver failure (ALF) and acute\u2010on\u2010chronic liver failure (ACLF) are associated with high mortality, and therapeutic plasma exchange (TPE) is increasingly used as a bridging therapy. This retrospective observational study evaluated outcomes and predictors of response in 22 liver failure patients undergoing TPE. Demographic details, hepatic encephalopathy (HE) grade, timing of TPE initiation, laboratory parameters, and clinical outcomes were analyzed. Clinical improvement was defined as \u2265\u20091\u2010grade HE improvement with hemodynamic stabilization and biochemical recovery. The mean age was 22.9\u2009years, with alcohol\u2010related liver failure and Wilson's disease being the most common indications. Patients with lower HE grades showed significantly better clinical improvement (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.031). Earlier initiation of TPE (&lt;\u200910\u2009days) demonstrated a trend toward improved outcomes, although not statistically significant. Significant reductions in bilirubin, INR, ALT, and AST were observed following TPE. However, biochemical improvement did not always correlate with clinical recovery. Early TPE may improve clinical and biochemical recovery and potentially prevent progression to advanced encephalopathy; however, larger prospective studies and randomized controlled trials are needed to establish the optimal timing of TPE and evaluate its prophylactic role in preventing worsening HE.\n                  <\/jats:p>","DOI":"10.1002\/jca.70131","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:50:28Z","timestamp":1778640628000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal Timing of Therapeutic Plasma Exchange and Hepatic Encephalopathy Severity as Predictors of Clinical Outcome in Liver Failure: A Retrospective Observational Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4904-5254","authenticated-orcid":false,"given":"Juilee Shalik","family":"Charmode","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2589-8315","authenticated-orcid":false,"given":"Soumya","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Aishwarya","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutwik","family":"Loya","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology All\u00a0India\u00a0Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinjari Chinigi","family":"Sab","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema","family":"Vijay","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9467-5759","authenticated-orcid":false,"given":"Rounak","family":"Dubey","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Fulzele","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine All India Institute of Medical Sciences  Nagpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.22043"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v13.i8.904"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2025.102550"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2019.05.003"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.09.034"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.10.036"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2021.07.010"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2023.11.003"},{"issue":"8","key":"e_1_2_13_10_1","first-page":"1729","article-title":"Standard\u2010Volume Plasma Exchange Improves Outcomes in Acute Liver Failure","volume":"19","author":"Maiwall R.","year":"2021","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"6","key":"e_1_2_13_11_1","first-page":"103288","article-title":"Early Therapeutic Plasma Exchange May Improve Treatment Outcomes in Severe Acute Toxic Hepatitis","volume":"60","author":"Berber I.","year":"2021","journal-title":"Transfusion and Apheresis Science"},{"issue":"4","key":"e_1_2_13_12_1","first-page":"1028","article-title":"Therapeutic Plasma Exchange Improves Systemic Inflammation and Survival in Acute\u2010On\u2010Chronic Liver Failure: A Propensity\u2010Score Matched Study From AARC","volume":"76","author":"Shasthry S. M.","year":"2022","journal-title":"Hepatology"},{"issue":"5","key":"e_1_2_13_13_1","first-page":"471","article-title":"Therapeutic Plasma Exchange in Acute Liver Failure: A Systematic Review","volume":"35","author":"Tan E. X.","year":"2020","journal-title":"Journal of Clinical Apheresis"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.70131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.70131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:16:40Z","timestamp":1782458200000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.70131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/jca.70131"],"URL":"https:\/\/doi.org\/10.1002\/jca.70131","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]},"assertion":[{"value":"2025-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70131"}}