Plasma exchange improves outcome of sepsis-associated liver failure: A case report

RATIONALE: Sepsis-associated liver failure is characterized by increased bilirubin levels and coagulation disorders, which has a significant impact on mortality due to the insufficient understanding of its complicated pathogenesis pathophysiology and a lack of standardized treatment. PATIENT CONCERNS: A 56-year-old woman presented signs of sepsis on the 2nd day after undergoing ureteroscopy for left ureter and laparoscopy for lysis of adhesions around left ureter due to hydronephrosis. Her condition seemed to have been improved after treatment, but the bilirubin levels suddenly increased drastically with presence of coagulation disorders. DIAGNOSIS: Laboratory tests combined with her medical history confirmed the diagnosis as sepsis-associated liver failure. INTERVENTIONS: Plasma exchange was applied after hepatoprotective drugs, and other supportive therapies were given which did not significantly improve the condition. OUTCOMES: Laboratory liver function tests indicated the restoration of damaged liver function after plasma exchange was performed and the patient was soon transferred from intensive care unit back to the general ward. LESSONS: Plasma exchange might be a vital and effective therapy to improve outcome of sepsis associated liver failure especially when conventional support therapy is ineffective.