Pig Liver Perfusion in the Treatment of Fulminant Hepatic Necrosis

This paper describes 4 patients with hepatic coma resulting from presumed viral hepatitis with massive liver cell necrosis, who were treated with pig liver perfusion alternating with exchange transfusion. None of the patients survived, but two showed a response to the program of treatment employed, in that there was an improvement in the level of consciousness. All patients died of haemorrhagic complications. The contribution of the oxygenator used in the circuit to the development of thrombocytopoenia is discussed, with reference to other circuits with and without oxygenators. Thrombocytopoenia may also result from disseminated intravascular coagulation in the patient, and from sequestration of platelets in the liver perfused with heterologous blood.