Plasma Exchange And Hemofiltration With Severe Hepatic Failure

Hepatic failure usually occurs in the patients with fulminant hepatitis or severe sepsis. The mortality for such patients is high if their hepatic failures do not recover. The uses of plasma exchange plus hemofiltration were tried in ten patients, five were due to severe sepsis and the other five were victims of fulminant hepatic failure. Three to five courses were treated every other day and their liver functions were followed. Their total bilirubin decreased 30%-55%, ammonia decreased 37%-54%. The cytokines levels also decreased. Three patients improved and survived more than 3 months, and the other seven patients expired though had temporary improvement. We concluded that plasma exchanges and hemofiltration can temporarily support patients with severe hepatic failure. The patient may survive if the sepsis was undercontrolled and their livers recovered well.