Abstract
The effect of exchange transfusion was assessed in comparison with other treatments in35 patients with fulminant hepatitis, of which were treated with exchange transfusion andthe others treated with a conservative therapy.
After the exchange transfusion therapy, 4 out of 10 (40%) recovered fully. In contrast, only 1 out of 25 (4%) recovered with a conservative therapy. Recovery of consciousnessoccurred in 60% of the patients treated by exchange transfusion and in 12% of those treatedby the conservative therapy. Prolongation of life was also obtained in the patients treatedwith exchange transfusion.
However, exchange transfusion therapy was not an absolute one, because it proved ineffectivein the patients of older ages, patients with very severe hepatocellular damage (unconjugatedbilirubin>40% of the total bilirubin, prothronbin time>40 sec.), or patients aftera duration of more than two weeks from the onset of illness.
One patient died of cerebral edema, although his liver was found to have regenerativeactivities at autopsy.
From these data, it was suggested that exchange transfusion in the treatment of fulminathepatitis should be the first choice in the patients of relatively young ages, or when hepatocellulardamage is not so severe.
The survival rate might increase if complications were prevented.
