Reversal of Acute Liver Failure Due to Wilson Disease by a Regimen of High-Volume Plasma Exchange and Penicillamine

Wilson's disease (WD) is a genetic disorder resulting in accumulation of copper in the liver and other organs. When presenting as acute liver failure (WD-ALF), urgent orthotopic liver transplantation (OLT) is considered the only life-saving option. The revised WD prognostic index is highly accurate in predicting death due to WD-ALF (1,2). For a score ≥11 acute listing for OLT is recommended in European and American guidelines. Here we report a patient with WD-ALF and poor prognostic score that was rescued by high-volume plasma exchange (HVP). This article is protected by copyright. All rights reserved.