{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:36:39Z","timestamp":1793306199259,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Paediatric acute liver failure (PALF) is a life\u2010threatening disease. Management aims to support hepatic regeneration or to bridge to liver transplantation. High\u2010volume plasmapheresis (HVP) removes protein\u2010bound substances, alleviates inflammation, and improves survival in adult acute liver failure. However, experience with HVP in PALF is limited. Aim of this study is to report on feasibility, safety, efficacy and outcomes of HVP in PALF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective observational study in children with PALF. HVP was performed upon identification of negative prognostic indicators, in toxic aetiology or multiorgan failure (MOF). Exchanged volume with fresh\u2010frozen plasma corresponded to 1.5\u20132.0 times the patient's estimated plasma volume. One daily cycle was performed until the patient met criteria for discontinuation, that is, liver regeneration, liver transplantation, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two children with PALF (body weight 2.5\u2013106\u2009kg) received 1\u20137 HVP cycles. No bleeding or procedure\u2010related mortality occurred. Alkalosis, hypothermia and reduction in platelets were observed. Haemolysis led to HVP termination in one infant. Seven children (32%) survived with their native livers, 13 patients (59%) underwent liver transplantation. Two infants died due to MOF. Overall survival was 86%. International normalization ratio (INR), alanine aminotransaminases (ALT), bilirubin and inotropic support were reduced significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) after the first HVP\u2010cycle (median): INR 2.85 versus 1.5; ALT 1280 versus 434\u2009U\/L; bilirubin 12.7 versus 6.7\u2009mg\/dL; norepinephrine dosage 0.083 versus 0.009\u2009\u00b5g\/kg\/min. Median soluble\u2010interleukin\u20102\u2010receptor dropped significantly following HVP (<jats:italic>n<\/jats:italic>\u2009=\u20097): 2407 versus 950\u2009U\/mL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HVP in PALF is feasible, safe, improves markers of liver failure and inflammation and is associated with lowering inotropic support. Prospective and controlled studies are required to confirm efficacy of HVP in PALF.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12211","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T10:44:12Z","timestamp":1713264252000},"page":"1364-1373","source":"Crossref","is-referenced-by-count":6,"title":["Role of high\u2010volume plasmapheresis in the management of paediatric acute liver failure"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0055-7452","authenticated-orcid":false,"given":"Johannes","family":"Hilberath","sequence":"first","affiliation":[{"name":"Paediatric Gastroenterology and Hepatology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Camelli","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology and Hepatology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"},{"name":"SSD Paediatric Gastroenterology Ospedale Infantile Regina Margherita Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Hofer","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology and Intensive Care University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Hartleif","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology and Hepatology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Nadalin","sequence":"additional","affiliation":[{"name":"General, Visceral and Transplant Surgery University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Peters","sequence":"additional","affiliation":[{"name":"General, Visceral and Transplant Surgery University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kumpf","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology and Intensive Care University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bevot","sequence":"additional","affiliation":[{"name":"Paediatric Neurology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Zirngibl","sequence":"additional","affiliation":[{"name":"Paediatric Nephrology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Weitz","sequence":"additional","affiliation":[{"name":"Paediatric Nephrology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekkehard","family":"Sturm","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology and Hepatology University Children's Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.12.051"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.04.050"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208937"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003134"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003268"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06576-y"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200109000-00015"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21737"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001826"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1492-7535.2003.00061.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.08.018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000511"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182134"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003108"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21848"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr115"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04769-z"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2022.22062"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2018.09.006"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001546"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001500"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1714098"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20352"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.11.021"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31829760cf"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001178"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31827a78b2"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.12.042"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12083"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.12211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T04:35:10Z","timestamp":1728880510000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpn3.12211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/jpn3.12211"],"URL":"https:\/\/doi.org\/10.1002\/jpn3.12211","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}