Fourteen children with acute viral hepatitis and hepatic coma were treated by conservative methods (low-protein diet, corticosteroids, neomycin sulfate) and exchange transfusion. Eleven patients were in grade 4 of hepatic coma, the other three in grade 3. The clinical and laboratory data presented by these patients before the exchange transfusion are analyzed. Seven patients survived which amounts to 50% of the group. A long-term follow-up study of six of them showed normal liver function and, in four, normal histological appearance of the liver by biopsy.
Zacarías J, Brinck P, Huidobro JG. Treatment of Hepatic Coma With Exchange Transfusion. Am J Dis Child. 1971;122(3):229-231. doi:10.1001/archpedi.1971.02110030087010