Acute Hepatic Coma Treated by Cross-Circulation or Exchange Transfusion

AASLD position paper

“…156 A variety of other strategies have been employed including exchange transfusion, charcoal hemoperfusion, extracorporeal liver perfusions, and intra-portal hepatocyte infusions. [157][158][159] To date, none can be recommended, and their use remains experimental. Efforts to improve hepatocyte regeneration have likewise been futile thus far.…”

Treatment of Hepatic Coma

“…The survival rate after this therapy is not significantly higher than with other methods as was optimistically believed in the past [8]. In particular, complications of blood clotting system determine the bad prognosis.…”

The elusive goal of liver support – quest for the Holy Grail

“…Abouna and his colleagues from Newcastle hold the record for the number of perfusions employed, reporting in 1970 a case of hepatorenal failure secondary to chronic hepatitis who had a total of 16 extracorporeal perfusions -10 pigs, 3 baboons, 1 calf, 1 monkey, 1 human, and the patient survived! 8a A more straightforward approach to whole liver support was reported by Burnell and colleagues in 1967, 9 namely cross-circulation with a human. The three patients treated had acute hepatic necrosis induced by the anaesthetic agent halothane, and one made a complete recovery.…”