Plasma exchange has become a readily available procedure for removal of abnormal
circulating proteins using blood cell separator, which is an ideal instrument for
performing a large-volume plasma exchange rapidly and with a minimum of difficulty.
Therapeutic role of plasma exchange have been shown in various diseases, such as
Waldenstrom's macroglobulinemia, Myasthenia gravis, Goodpasture's syndrome and
autoiumune hemolytic anemia.
Fulminant hepatitis with coma remains a highly lethal disease, and a therapeutic
enigma and challenge despite the trial of many orthodox treatment.
There were some reports subjected to plasma exchange on the theory that removal of
the patient's plasma would eliminate or reduce circulating noxious substance and that
the procedure could support the patient through the critical period required for
hepatocyte regeneration.
Recently, we did a clinical trial of plasms exchange of 3 liters, daily for 3 days with
the replacement of fresh frozen plasma using cell seporater (Haemonetics Model 30S).
Following the plasma exchange, the patient showed remarkable improvement in her
mental state and laboratory findings. Nevertheless, the patient died of pulmonary, edema
and electrolyte imbalance.
Here, the authors report a clinical trial of plasma exchange for a patient with acute
fulminant hepatitis with coma.
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