A patient with extensive trauma to liver and shock was treated by hepatic lobectomy rather than suture and packing. Hepatic coma was noted on the fifth postoperative day and exchange blood transfusions were performed on the seventh and eighth days. The patient became conscious with each exchange. The patient subsequently recovered. Repeated exchange blood transfusions may be useful in sustaining the patient following extensive hepatic resection until regeneration can occur.
Barlyn LW, Trey C, Fagan JF, McDermott WV. Exchange Transfusion for Fulminant Hepatic Failure Following Hepatic Resection. Arch Surg. 1971;102(3):224-226. doi:10.1001/archsurg.1971.01350030062019