ArticleJournal of clinical and experimental hepatology
Improving Transplant-free Survival With Low-volume Plasma Exchange to Treat Children With Rodenticide Induced Hepatotoxicity.
Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Role of therapeutic plasma exchange on survival in pediatric acute liver failure and acute-on chronic liver failure: A systematic review and meta-analysis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Pooled it
- Safety and efficacy of plasmapheresis in treatment of acute fatty liver of pregnancy-a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Rotational thromboelastometry helped reduce prophylactic blood product use for port insertion in patients with liver failure undergoing plasma exchange.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Plasma exchange to treat liver failure: The field expands.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Liver support systems and liver transplantation in acute liver failure.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Non-bioartificial liver support system in the treatment of pediatric acute liver failure.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2025Review
- Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2024Review
- Yellow phosphorus poisoning: is preemptive PLEX therapy feasible?The Lancet regional health. Southeast Asia · 2024Article
- The "Hub and Spoke" model: a pathway for urgent plasma exchange to treat patients with rodenticide ingestion induced acute liver failure in Tamil Nadu, India.The Lancet regional health. Southeast Asia · 2024Article
- Critical care management of acute liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Management of Yellow Phosphorus-Induced Acute Liver Failure: A Case Report and Review of Literature.Cureus · 2024Article
- Therapeutic Plasma Exchange in Certain Immune-Mediated Neurological Disorders: Focus on a Novel Nanomembrane-Based Technology.Biomedicines · 2023Review
- Therapeutic Plasma Exchange in Hepatology: Indications, Techniques, and Practical Application.Journal of clinical and experimental hepatologyReview
- Von Willebrand Factor as a Biomarker for Liver Disease - An Update.Journal of clinical and experimental hepatologyReview
- Growing Evidence for Survival Benefit with Plasma Exchange to Treat Liver Failure.Journal of clinical and experimental hepatologyReview
- Low-Volume Plasma Exchange to Treat Children with Acute Liver Failure.Journal of clinical and experimental hepatologyArticle
- Single-Centre Experience With Low-Volume Plasma Exchange and Low-Dose Steroid to Treat Patients With Idiosyncratic Drug-Induced Acute Liver Failure.Journal of clinical and experimental hepatologyArticle
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Authors and funding
19 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In a prior report, no patient with rodenticidal hepatotoxicity who met Kochi criteria (MELD score ≥36 or baseline INR ≥6 with hepatic encephalopathy) (PMID: 26310868) for urgent liver transplantation survived with medical management alone. Plasma exchange (PLEX) may improve survival in these patients. Objectives: We describe our experience with low-volume PLEX (PLEX-LV) in treating rodenticide ingestion induced hepatotoxicity in children. Methods: From prospectively collected database of rodenticidal hepatotoxicity patients managed as in-patient with department of Hepatology from December 2017 to August 2021, we retrospectively studied outcomes in children (≤18 years). Hepatotoxicity was categorized as acute liver injury (ALI, coagulopathy alone) or acute liver failure (ALF, coagulopathy and encephalopathy). Kochi criteria was used to assess need for urgent liver transplantation. The primary study outcome was one-month survival. Results: Of the 110 rodenticidal hepatotoxicity patients, 32 children (females: 56%; age: 16 [4.7-18] years; median, range) constituted the study patients. The study patients presented 4 (1-8) days after poison consumption (impulsive suicidal intent:31, accidental:1). Twenty children (62%) had ALI [MELD: 18 (8-36)] and 12 (38%) had ALF [MELD: 37 (24-45)].All children received standard medical care, including N-acetyl cysteine; ALF patients also received anti-cerebral edema measures. None of the patient families opted for liver transplantation. Seventeen children (ALI: 6, ALF: 11) were treated with PLEX-LV (3 [1-5] sessions, volume of plasma exchanged per session: 26 [13-38] ml/kg body weight) and peri-procedure low dose prednisolone.At 1 month, 28 of the 32 children (87.5%) were alive (4 ALF patients died). Of 10 children who met Kochi listing criteria for urgent liver transplantation, two children were ineligible for PLEX-LV (due to hemodynamic instability) and of the remaining 8 children treated by PLEX-LV, 6 (75%) survived. Conclusions: PLEX-LV shows promise as an effective non-liver transplant treatment in children with rodenticidal hepatotoxicity.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.