Abstract
The significance of blood purification for patients with acute and chronic types of postoperative liver failure was studied. Blood purification, mainly plasma exchange(PE), was carried out for 13 cases of acute type and 2 cases of chronic type of postoperative liver failure. Four out of 13 cases (31%) survived. Although only 1 case of 8 cases accompanying with chronic liver diseases survived, 3 cases out of 5 without chronic liver diseases could survive. In the most of the survival cases, other organ failures were less occurred, and total bilirubin and blood ammonia before PE were less than 15mg/dl and 200ug/dl, respectively. In addition total bilirubin, blood ammonia and BCAA/AAA ratio were quickly recovered within 5 sessions of PE in such cases. PE as a chronic liver support for 2 patients with postoperative liver failure was effective in reducing jaundice and in improving consciousness and general condition. PE should be introduced early by assessing the changes in total bilirubin, blood ammonia and casa grade in the patients with acute type postoperative liver failure. PE could be useful as a chronic support system for those awaiting liver transplantation.
