Therapeutic plasma exchange improves short-term survival in patients with acute-on-chronic liver failure: A randomized controlled trial
Shekhar Swaroop·Shalimar·Arnav Aggarwal·Poonam Coshic·Sonu Kumar·Samagra Agarwal·Hem Chandra Pandey·Gopal Kumar Patidar·Rahul Chaurasia·Umang Arora·Ayush Agarwal·Pragyan Acharya·Baibaswata Nayak·Deepak Gunjan·Viren Sardana·Ashwani Kumar Mishra·Shivanand Gamanagatti·Sagnik Biswas
Background: This randomized controlled trial (RCT) evaluated the efficacy and safety of Therapeutic plasma exchange (TPE) versus standard medical therapy (SMT) in ACLF. Methods: In this single-center, open-label RCT (February 2022-March 2025), we randomly (1:1) assigned 194 adult patients (aged 18-60 y) with ACLF (European Association for the Study of the Liver-Chronic Liver Failure Consortium [EASL CLIF-C] Grades 1–3b) to receive SMT plus 5 sessions of TPE (n=97) or SMT alone (n=97). The primar