{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:40:18Z","timestamp":1789609218964,"version":"build-2803163510"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T00:00:00Z","timestamp":1479340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001870","name":"Fundacja na rzecz Nauki Polskiej","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001870","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>The amelioration of refractory cholestatic pruritus after plasmapheresis has been reported in single patients. Here, we analyse the efficacy of plasmapheresis in a cohort of patients with primary biliary cholangitis (<jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventeen consecutive patients with<jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>(age range 39\u201085\u00a0years, 16 females, 9 with cirrhosis) and refractory pruritus underwent 129 plasmapheresis procedures during 40 admissions. Pruritus was quantified by the 10\u2010point numeric rating scale (<jats:styled-content style=\"fixed-case\">NRS<\/jats:styled-content>) before and after plasmapheresis, as well as ~30 and ~90\u00a0days later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean pruritus before plasmapheresis did not differ between patients with and without cirrhosis (<jats:italic>P<\/jats:italic>&gt;.05). Cirrhotics presented, however, with significantly higher serum alanine aminotransferase (<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>), aspartate transaminase (<jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>), gamma\u2010glutamyl transpeptidase (<jats:styled-content style=\"fixed-case\">GGT<\/jats:styled-content>), alkaline phosphatase (<jats:styled-content style=\"fixed-case\">ALP<\/jats:styled-content>) and bilirubin before plasmapheresis. Plasmapheresis decreased itching to NRS\u22645 in all but five admissions: Mean pruritus decreased from 8.3\u00b11.4 to 3.1\u00b12.2 (<jats:italic>P<\/jats:italic>&lt;.0001) in the entire cohort. It also led to a significant decrease in serum<jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">ALP<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">GGT<\/jats:styled-content>(all<jats:italic>P<\/jats:italic>&lt;.001) and bilirubin (<jats:italic>P<\/jats:italic>=.002). Antipruritic effect persisted throughout the 90\u2010days follow\u2010up (<jats:italic>P<\/jats:italic>&lt;.0001). The amelioration of pruritus was not affected by the presence of cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plasmapheresis is a promising method for reducing intractable itch in a significant proportion of<jats:styled-content style=\"fixed-case\">PBC<\/jats:styled-content>patients regardless of liver fibrosis. Long\u2010lasting improvement of symptoms requires repeated procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13281","type":"journal-article","created":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T07:46:40Z","timestamp":1477381600000},"page":"743-747","source":"Crossref","is-referenced-by-count":25,"title":["Plasmapheresis exerts a long\u2010lasting antipruritic effect in severe cholestatic itch"],"prefix":"10.1111","volume":"37","author":[{"given":"Marcin","family":"Krawczyk","sequence":"first","affiliation":[{"name":"Laboratory of Metabolic Liver Diseases Department of General, Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland"},{"name":"Department of Medicine II Saarland University Medical Center Saarland University Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Liebe","sequence":"additional","affiliation":[{"name":"Department of Medicine II Saarland University Medical Center Saarland University Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Wasilewicz","sequence":"additional","affiliation":[{"name":"Liver and Internal Medicine Unit Department of General, Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Wunsch","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Biochemistry Pomeranian Medical University in Szczecin Szczecin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Raszeja\u2010Wyszomirska","sequence":"additional","affiliation":[{"name":"Liver and Internal Medicine Unit Department of General, Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Milkiewicz","sequence":"additional","affiliation":[{"name":"Liver and Internal Medicine Unit Department of General, Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland"},{"name":"Department of Clinical and Molecular Biochemistry Pomeranian Medical University in Szczecin Szczecin Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26909"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.04.009"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00108-015-3755-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840190629"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.13.12.976"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.26.3.291"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920020303"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1998.tb01952.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-15-128"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4103\/0972-2327.144301","article-title":"Plasmapheresis 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