The Role and Efficacy of Plasmapheresis in Acute Liver Failure Due to Hepatitis E Viral Hepatitis.

Acute liver failure, due to hepatitis E virus (HEV) infection, represents a serious problem in developing countries, lacking access to liver transplantation. Therapeutic plasma exchange has become one potential bridge therapy, which has improved results by elimination of circulating toxins/inflammatory mediators, and ammonia. We describe the clinical course of a 31-year-old man who developed fulminant hepatic failure secondary to HEV infection. After conventional treatment, the patient underwent 5 sessions of plasmapheresis that was associated with marked biochemical and neurological recovery. This case provides support for plasmapheresis as a useful adjunct in the management of HEV-induced acute liver failure and its applicability in resource limited settings where liver transplantation is not available.