Evidence map›Paper›PMID 40035795›Full record

SynthesisIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2025

Role of therapeutic plasma exchange on survival in pediatric acute liver failure and acute-on chronic liver failure: A systematic review and meta-analysis.

Kalpana Panda, Devi Prasad Dash, Prateek Kumar Panda, Mrutunjay Dash, Prasant Kumar Saboth, Girish Kumar Pati

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kalpana PandaDivision of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India. drkalpanapanda@gmail.com.ORCID 0000-0002-7280-5743
Devi Prasad DashDepartment of Critical Care Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, 751 024, India.
Prateek Kumar PandaDepartment of Pediatrics, All India Institute of Medical Sciences, Rishikesh, 249 203, India.
Mrutunjay DashDepartment of Pediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India.
Prasant Kumar SabothDepartment of Pediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India.
Girish Kumar PatiDepartment of Gastroenterology and Hepatology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTherapeutic plasma exchange (TPE) has emerged as a promising treatment option for pediatric liver failure (PLF) either as a standalone therapy or as a bridge to liver transplant; however, its precise impact on survival outcomes has not been investigated systematically to date. This meta-analysis aims to evaluate the effect of TPE on survival of pediatric patients with liver failure. 

methodsPubMed, Scopus and Embase databases were searched to include all studies till August 2024 reporting the effect of TPE on survival of acute and acute-on-chronic liver failure patients of age < 18 years. Primary outcome measures were overall survival (OS) and transplant-free survival (TFS) at Day ≥ 28 in pediatric acute liver failure (PALF) and pediatric acute-on-chronic liver failure (pACLF) patients undergoing TPE. The secondary outcome measure was to determine changes in biochemical parameters (international nrmalized ratio [INR], bilirubin and ammonia) pre and post-TPE in them.

resultsTwelve studies (8 = exclusive PALF cohorts and 4 = combined PALF + pACLF cohorts) comprising 310 patients (273 = PALF and 37 = pACLF) who received TPE were included. Pooled OS at Day ≥ 28 for PLF after TPE is 61% (95% CI: 55-66%, p = 0.03, I

conclusionTPE shows the potential to improve overall survival in pediatric liver failure, mostly acting as a bridge to liver transplant or native liver recovery. Further, well-designed, adequately powered, randomized-controlled trials are needed to confirm TPE's survival benefit in PLF.

Indexed as

Acute-On-Chronic Liver FailureLiver Failure, AcutePlasma ExchangeAdolescentChildChild, PreschoolFemaleHumansInfantMaleSurvival RateTreatment OutcomeAcute liver failureAcute-on-chronic liver failureOverall survivalPediatricPlasma exchangeTransplant free survival

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Registered trials

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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.