Acute Hepatic Coma Treated by Cross-Circulation or Exchange Transfusion

Abstract

THE likelihood of survival from acute massive hepatic necrosis with deepening coma is extremely poor. For this reason, efforts have been made to provide additional temporary support by means of exchange transfusion,¹³ heterologous liver perfusion^{4 , 5} and human cross-circulation,⁶ to permit regeneration of liver parenchyma. This report describes the management of 4 cases of acute massive hepatic necrosis with progressing deep coma after repeated halothane anesthesia and 1 case of viral hepatitis with coma. Three patients were treated by cross-circulation, and 2 by exchange transfusion. Four cross-circulation partners were utilized, 3 normal subjects and 1 with cancer.MethodsCross-circulation was performed . . .