Plasma exchange therapy for post-operative hepatic failure.

概要

論文の詳細を見る
Plasma exchange (P.E.) therapy for post-operative hepatic failure was not effective when it was applied to a patient who developed advanced hepatic failure of extreme jaundice and deep consciousness disturbance. Then, P.E. was performed in the early stage of hepatic failure predicted by the activity of lecithin cholesterol acyltransferase (LCAT), an accurate predictor of post-operative hepatic failure. The indicative criteria for P.E. therapy were prescribed in the case: 1) who ceased producing LCAT activity, and 2) within grade 2 (Sherlock) of consciousness disturbance, 3) 35% or more of prothrombin time, 4) less than 10mg/dl of total bilirubin. LCAT activity was a useful indicator for evaluation of effectiveness during P.E. therapy. According to these criteria, 5 cases out of 14 (36%) recovered from hepatic failure and 4 cases (29%) lived more than one month after the first P.E.
社団法人日本肝臓学会の論文