Health Condition 1: K754- Autoimmune hepatitis
Conditions
Interventions
Intervention1: Plasma Exchange with Steroid: For plasma Exchange
Route: Intravenous
Dose: Normal Volume Plex
Frequency: Alternate day 3 to 5 sessions
Duration: Tentative 10 days
For Steroid
Route: Ora
Sponsors
Institute of Liver and Biliary Sciences
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age 18-60 years 2. Acute severe autoimmune hepatitis with MELD more than 24 3. No liver transplant option less than 28 days. 4. ACLF and Non ACLF 5. Auto immune hepatitis: Diagnosis by simplified AIH score more than equals to 6
Exclusion criteria
Exclusion criteria: 1. Patients with Active sepsis 2. Patients with Active bleeding 3. Patients allergic to FFP and blood products 4. Patients with unstable hemodynamics ( eg BP less than 90 by 60 mmhg,HR more than 100bpm) 5. Patients with post renal obstructive AKI, AKI suspected due to glomerulonephritis, interstitial nephritis or vasculitis based on clinical history and urine analysis 6. Pregnancy related liver failure 7. Comorbidities associated with poor outcome (Extrahepatic neoplasia, severe cardiopulmonary disease defined by a New York Heart Association score more than 3, or oxygen/steroid-dependent chronic obstructive pulmonary disease) 8. Refusal to participate in the study 9. Patients who are eligible to transplant 10. Patients who received steroids or on steroids last 7 days
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reduction in AST,ALT,BilirubinTimepoint: 28 days | — |
Secondary
| Measure | Time frame |
|---|---|
| Liver transplant free survival at 28 daysTimepoint: 28 days;Development of adverse event due to TPE.Timepoint: 28 days;Development of clinical infection during study period.Timepoint: 28 days;Mortality during hospital stay.Timepoint: 28 days;Post therapy assessment in the form of clinical improvement (hepatic encephalopathy, ascites , improvement in jaundice)(both ascites and HE if present).Timepoint: 28 days;Frequency of decompensation events on follow up period.Timepoint: 28 days;Infections at 28 days.Timepoint: 28 days | — |
Countries
India
Contacts
Public ContactDr Satender Pal Singh
Institute of Liver and Biliary Sciences
Outcome results
None listed