Pachisia AV, Govil D, Jagadeesh K, Patel SJ, Harne R, Pal D, Tyagi P, Pattajoshi S, Brar K, Patel P, Zatakiya R. Extracorporeal therapies for post-liver transplant recipient: The road less traveled. World J Transplant 2025; 15(3): 101975 [DOI: 10.5500/wjt.v15.i3.101975]
Corresponding Author of This Article
Deepak Govil, MBBS, MD, EDIC, Vice Chair, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Deepak Govil, Gurugram 122001, Haryana, India. drdeepak_govil@yahoo.co.in
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Anant Vikram Pachisia, Deepak Govil, KN Jagadeesh, Sweta J Patel, Rahul Harne, Divya Pal, Pooja Tyagi, Swagat Pattajoshi, Keerti Brar, Parimal Patel, Ronak Zatakiya, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurugram 122001, Haryana, India
Author contributions: Pachisia AV and Govil D drafted the manuscript and artwork; Jagadeesh KN, Patel SJ, Harne R, Pal D, Tyagi P, Pattajoshi S, Brar K, Patel P, and Zatakiya R conducted the literature review; All authors approved the submitted manuscript.
Conflict-of-interest statement: Deepak Govil has received fees for serving as a speaker, consultant, and/or an advisory board member for Baxter (I) Ltd, Nestle (I) Ltd, Cipla Ltd, Pfizer Ltd, Fresenius Kabi (I) Pvt, Wockhardt Ltd. Deepak Govil is an employee of Medanta-The Medicity (Global Health Limited). Anant V Pachisia, KN Jagadeesh, Sweta J Patel, Rahul Harne, Divya Pal, Pooja Tyagi, Swagat Pattajoshi, Keerti Brar, Parimal Patel, Ronak Zatakiya are employee of Medanta-The Medicity (Global Health Limited).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deepak Govil, MBBS, MD, EDIC, Vice Chair, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Deepak Govil, Gurugram 122001, Haryana, India. drdeepak_govil@yahoo.co.in
Received: October 3, 2024 Revised: January 25, 2025 Accepted: February 17, 2025 Published online: September 18, 2025 Processing time: 196 Days and 20.5 Hours
Abstract
Extracorporeal therapies have a definite role in patients with acute liver failure, acute on-chronic liver failure, and progressive chronic liver disease. They act as a bridge-to-transplant in these patients. With the increasing success of liver transplantation, the immediate postoperative complication spectrum continues to expand. Extracorporeal therapies can play an important role in managing these complications. However, the literature on extracorporeal therapies in the post-liver transplant period is limited. This review article discussed various extracorporeal therapies that are still evolving or marred by limited evidence but can improve patient outcomes. These extracorporeal therapies can be divided into two subgroups: (1) Therapies for infective complications. Endotoxin and cytokine adsorption columns; and (2) Therapies for noninfective complications like small for size syndrome, primary allograft nonfunction, early allograft dysfunction, hyperacute rejection, hepatopulmonary syndrome, etc. (plasma exchange, double plasma molecular adsorption, molecular adsorbent recirculation system, and extracorporeal membrane oxygenation, among others).
Core Tip: With the growing number of liver transplants, both infective and noninfective complications are bound to grow. The discussion on extracorporeal therapies sheds light on innovative approaches that may improve patient outcomes, showcasing advancements in medical technology. By acknowledging the limited literature and ongoing research, the article highlighted the need for further studies to validate the efficacy and safety of these emerging therapies, which is crucial for informed clinical practice.
