Chronic therapeutic plasma exchange for poor-prognosis primary biliary cirrhosis patients awaiting liver transplantation

Therapeutic plasma exchange (TPE) has been demonstrated as palliative for hyperlipidemia and pruritus in PBC. We initiated chronic TPE for seven patients with PBC who had intractable symptoms secondary to hypercholesterolemia and/or pruritus and who had failed conventional therapy. We observed that this group had a much longer than expected survival than would have been predicted from their prognostic indicators. This allowed two patients to obtain timely liver transplants.