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December 28, 1970

Acute Hepatic Coma Treated by Cross Circulation With Irreversibly Comatose Donor

Author Affiliations

From the departments of internal medicine and surgery, University of Iowa College of Medicine, Iowa City.

JAMA. 1970;214(13):2297-2301. doi:10.1001/jama.1970.03180130031008

A patient developed acute hepatic failure and encephalopathy after massive resection of the liver for a primary hepatic neoplasm. Coma deepened despite medical therapy and exchange transfusion, but responded dramatically to cross circulation with an irreversibly brain-damaged individual. The patient survived 20 days following crosscirculation therapy, which allowed time for complete hepatic regeneration, but she ultimately died from recurrent infection and portal-vein thrombosis. The cross-circulation procedure is safe, effective, and technically simple to perform.