In this prospective randomized controlled trial Investigator aim to evaluate the impact of high versus standard volume plasma-exchange in patients with acute liver failure with cerebral edema and clinical outcomes. ALF who meet the inclusion and exclusion criteria within the first 12 hours will be randomized into two groups
Interventional - High-volume plasma exchange Active Comparator - Standard volume plasma exchange
Expected outcome of the project-.
1. Primary end points: Time to improvement in cerebral edema 2. Secondary end points:
To study the adverse events of therapy (volume overload, pulmonary complications, allergic reactions) etc.
Transplant-free survival at day 21
None
Age <18 or > 70 years
HCC
Active untreated Sepsis/DIC
Hemodynamic instability non-responsive to initial fluid resuscitation with norepinephrine >0.1 ug/kg/min