تشمع الكبد اللاتعويضي في مرض ويلسون: عندما لا يُجدي العلاج بالاستخلاب

References

DOI: 10.1016/j.jhep.2024.11.007

Patients with decompensated cirrhosis in WD may respond to medical therapy, usually after >3 months of treatment, but they should be concomitantly evaluated for LT (LoE 3, strong recommendation, strong consensus).

Essentially, all patients with WD and decompensated chronic liver disease who fail to respond to or tolerate medical therapy should be considered promptly for transplantation.

Case series and small observational studies suggest that dialysis, plasmapheresis, albumin dialysis and high-volume plasma exchange can be considered as bridging therapies to LT in patients with WD ALF, especially once excess copper is detectable within the plasma.