Therapeutic plasma exchange in amatoxin associated acute liver failure-results from the multi-center Amanita-PEX study.

ABSTRACT:

Background

Amatoxin-related acute liver failure (AT-ALF) carries high mortality without liver transplantation (LTX). While therapeutic plasma exchange (PEX) might improve LTX-free survival in other ALF cases, its role in AT-ALF is unclear. Clinical practice varies, and, given the rarity of this ALF entity, the feasibility of conducting a randomized controlled trial to investigate PEX in AT-ALF is more or less impossible.

Methods

The Amanita-PEX study is a multi-center, international, retrospective study analyzing patients with AT-ALF from 2013 to 2024. The primary outcome was 28-day LTX-free survival (composite endpoint: death or LTX) after ALF diagnosis.

Results

The study included 111 patients from 25 centers: 82 received standard-of-care (SOC), and 29 received at le

SUBMITTER: Stahl K 

PROVIDER: S-EPMC12573913 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature