Therapeutic plasma exchange in Amatoxin-associated paediatric acute liver failure—results from the Amanita-PEX study

The retrospective multicentre Amanita-PEX study examined outcomes and the role of therapeutic plasma exchange in children with amatoxin-associated acute liver failure.

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Outcomes of amanita toxin-induced paediatric acute liver failure (AT-PALF) were investigated a retrospective multicenter cohort study with a combined primary endpoint of 28-day transplant-free survival. 30 patients from 30 centers were included, with an overall 28-day transplant-free survival rate of 53.3% and a mortality of 10%. Outcomes mainly depended on the severity of liver injury and multi-organ dysfunction. Common treatments included N-acetylcysteine (all patients) and silibinin (93% of patients). However, therapeutic plasma exchange (47% of patients) was not associated with improved outcomes.

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