Treatment of hepatic coma with exchange transfusion and peritoneal dialysis

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Abstract
A 17-year-old boy developed hepatic coma while being treated in the hospital for acute hepatitis. Since the usual therapeutic measures failed to reverse the clinical deterioration, exchange transfusion was used. Banked acid-citrate-dextrose blood, with an average age of 7 days, was used. Peritoneal dialysis was used concurrently in an attempt to prevent the potential problem of an increase in ammonia levels, the result of the exchange with old blood. This therapy was associated with gradual but steady clinical improvement and a striking reduction in the serum bilirubin levels.

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