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Abstracts |

Plasmapheresis with Plasma Exchange in Hepatic Coma.

Michael J. Lepore, M.D., F.A.C.P.; and Anthony J. Martel, M.D.
Ann Intern Med. 1969;70(5):1069. doi:10.7326/0003-4819-70-5-1069_2
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Failure of patients in hepatic coma to respond to hemodialysis or peritoneal dialysis and their improvement after exchange transfusions suggests that a protein-bound nondialyzable factor may be involved. Such a factor might be removed selectively by bleeding the patient, separating and discarding his plasma, and returning to him his own red cells plus fresh, frozen human plasma—that is, plasmapheresis with plasma exchange.

We have used this technique in a series of patients with severe hepatic disease. This report describes our experience with this procedure in four patients in hepatic coma due to fulminant, massive hepatic necrosis. All four patients were


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