Severe hepatocellular damage and acute anuric renal failure following a grade V hepatic injury treated by plasmapheresis and hemodialysis

Authors

  • Suvit Sriussadaporn Department of Surgery, Faculty of Medicine, Chulalongkorn University
  • Pranee Sutcharitchan Department of Medicine, Faculty of Medicine, Chulalongkorn University
  • Manoch Teiachokviwat Department of Medicine, Faculty of Medicine, Chulalongkorn University
  • Thananda Trakanvanich Department of Medicine, Faculty of Medicine, Chulalongkorn University

Keywords:

Plasmapheresis, post-traumatic liver failure

Abstract

A case of severe hepatocellular damage and acute anuric renal failure following a gradeV hepatic injury is presented. Renal shutdown began on the third admission day. The patient also developed progressive hyperbilirubinemia and acute liver failure. His condition deteriorated in spite of intensive supportive care and aggressive hemodialysis. Billirubin level reached 51.4 mg/dL on the 13th admission day and plasmapheresis with plasma exchange was considered necessary to decrease his bilirubin levels. Intermittent hemodialysis and plasmapheresis were undertaken until the kidneys recovered following which the hepatic function rapidly returned to normal. We conclude that although hepatic function after severe hepatic injury usually returns to normal with conventional supportive therapy and the benefit of plasmapheresis in this patient is unclear, plasmapheresis may have a role in desperate situation of liver and renal failure in which the renal failure may be further aggravated and never recover in the presence of very high bilirubin levels. Plasmapheresis reduces bilirubin levels and probably other harmful metabolites while awaiting recovery of the renal function.

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Published

1996-03-29

How to Cite

1.
Sriussadaporn S, Sutcharitchan P, Teiachokviwat M, Trakanvanich T. Severe hepatocellular damage and acute anuric renal failure following a grade V hepatic injury treated by plasmapheresis and hemodialysis. Thai J Surg [Internet]. 1996 Mar. 29 [cited 2024 Jul. 18];17(1):17-21. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/250178

Issue

Vol. 17 No. 1 (1996): January - March

Section

Original Articles

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.