Plasmapheresis as an alternative to high-dose intravenous immunoglobulin in the prevention of gestational alloimmune liver disease

Abstract

Gestational alloimmune liver disease occurs due to trans-placental passage of maternal antibodies to a fetal hepatocyte antigen that produces complement-mediated hepatocyte injury. High-dose intravenous immunoglobulin therapy during gestation is highly effective at decreasing the risk to the neonate but treatment is expensive. This case presents for the first time the use of plasmapheresis as a potential cheaper alternative when treatment with immunoglobulins is unavailable.