A Case Report of Hepatorenal Syndrome Treated With Plasma Diafiltration (Selective Plasma Filtration with Dialysis)

Abstract

Plasma diafiltration (PDF) (selective plasma filtration with dialysis) is blood purification therapy in which simple plasma exchange is performed using a membrane plasma separator (Evacure EC-2A) while dialysate flows outside of the hollow-fibers. A 74-year old man with hepatorenal syndrome underwent four sessions of PDF and three sessions of HDF. Finally he recovered from hepatorenal syndrome. In this therapy, the levels of total bilirubin, interleukin-18, creatinine, and cystatin C were significantly reduced. On the other hand, there were no significant differences in the total protein and albumin levels before and after PDF. PDF may be one of the most useful blood purification therapies for hepatorenal syndrome in terms of medical economics.

Multicenter Study of Plasma Diafiltration in Patients With Acute Liver Failure

“…We have previously reported on the effectiveness of PDF in patients with acute liver failure (7–9). Here, we report the results of a prospective multicenter trial using PDF in patients with liver failure.…”

A Case Report of Pediatric Fulminant Hepatitis Treated With Plasma Diafiltration

“…Plasma diafiltration (PDF) is blood purification therapy in which simple plasma exchange (PE) is performed with a membrane plasma separator while dialysate flows outside the hollow fibers. PDF, requiring about one‐third of the amount of fresh frozen plasma (FFP) required by conventional PE, may yield results similar to those of conventional PE (1,2). We have previously reported the effectiveness of PDF in adults with acute liver failure (2); here, we report the first case of a pediatric patient who underwent PDF for the treatment of fulminant hepatitis.…”

Role of plasma exchange, leukocytapheresis, and plasma diafiltration in management of refractory macrophage activation syndrome

“…The Evacure EC‐2 A plasma separator has a pore size of .01 mm, which is much smaller than that of the standard plasma separation membrane (0.2–0.4 mm). This membrane has a sieving coefficient of 0.3 for albumin and thus can selectively remove low or intermediate molecular weight albumin‐bound substances . In addition, coagulation factors are preserved in the process because this membrane has a sieving coefficient of 0 for fibrinogen .…”

“…Plasma diafiltration (PDF) is a blood purification therapy in which simple PE is performed using a selective membrane plasma separator (Evacure EC‐2 A plasma separator; Kuraray, Tokyo, Japan) while the dialysate flows outside the hollow fibers . PDF has some advantages compared with PE.…”