Clinical value of plasma exchange in treating patients with acute fatty liver of pregnancy

Abstract

Objective To explore the application value of plasma exchange in treating acute fatty liver of pregnancy (AFLP). Methods This study collected the clinical data of 17 AFLP patients, who were treated with plasma exchange in the obstetrics department of The Third Affiliated Hospital of Sun Yat-sen University from January 2010 to December 2013. Symptoms, physical signs, hepatorenal function, coagulation function before and after treatment of plasma exchange and the adverse effects were retrospectively analyzed. Results (1) Compared with before treatment and after treatment, white blood cell, aspartate transaminase, alanine aminotransferase, total bilirubin, prothrombin time, urea and uric acid were obviously improved (P<0.05). Before treatment, white blood cell, aspartate transaminase, alanine aminotransferase, total bilirubin, prothrombin time, urea and uric acid were(20.2±9.1)×109/L, (304.3±312.6)U/L, (332.5±348.3)U/L, (130.5±113.6)μmol/L, (22.5±6.3)s, (9.6±7.8)mmol/L, (515.3±167.0)μmol/L, respectively. After treatment, they were (15.2±5.9)×109/L, (81.4±99.5)U/L, (116.7±198.9)U/L, (84.3±35.5)μmol/L, (19.6±6.7)s, (7.6±4.2)mmol/L, (380.0±219.4)μmol/L, respectively.(2) Adverse reactions during plasma exchange were generally mild and tolerable, and no patients discontinued treatment due to adverse events. Conclusion Plasma exchange is safe and effective for the AFLP patients, and timely application of plasma exchange after termination of pregnancy can effectively reverse the progression of AFLP. Key words: Fatty Liver; Acute disease; Pregnancy complications; Plasma exchange