Skip to main content
British Medical Journal logoLink to British Medical Journal
. 1972 Jan 1;1(5791):23–25. doi: 10.1136/bmj.1.5791.23

Acute Hepatic Coma Successfully Treated by Extracorporeal Baboon Liver Perfusions

G M Abouna, L McA Fisher, W J Still, D M Hume
PMCID: PMC1789106  PMID: 5061783

Abstract

Two patients in deep hepatic coma due to fulminant viral hepatitis were treated by extracorporeal baboon liver perfusion after failing to respond to medical treatment and three consecutive exchange transfusions. Both patients recovered full consciousness after one liver perfusion, made a complete recovery, and were leading normal lives seven and eight months after treatment. Perfusions were maintained for 13½ and 16½ hours without complication, and neither clinical immunological reactions nor antibaboon serum antibodies developed as a result of treatment.

Whereas normal consciousness could be restored only by liver perfusion, both exchange transfusion and liver perfusion were effective in clearing bilirubin and in raising the level of clotting factors. Extracorporeal baboon liver perfusion provides a safe and effective method for the treatment of acute hepatic coma.

Full text

PDF
23

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abouna G. M., Boehmig H. G., Serrou B., Amemiya H., Martineau G. Long-term hepatic support by intermittent multi-species liver perfusions. Lancet. 1970 Aug 22;2(7669):391–396. doi: 10.1016/s0140-6736(70)90006-1. [DOI] [PubMed] [Google Scholar]
  2. Abouna G. M. Extracorporeal liver perfusion using a new perfusion chamber. Lancet. 1968 Dec 7;2(7580):1216–1218. doi: 10.1016/s0140-6736(68)91696-6. [DOI] [PubMed] [Google Scholar]
  3. Abouna G. M., Koo C. G., Howanitz L. F., Ancarani E., Porter K. A. Successful orthotopic liver transplantation after preservation by simple hypothermia. Transplant Proc. 1971 Mar;3(1):650–653. [PubMed] [Google Scholar]
  4. Benhamou J. P., Rueff B., Sicot C. Etude critique des traitements actuels de l'insuffisance hépatique grave. Rev Fr Etud Clin Biol. 1968 Aug-Sep;13(7):651–658. [PubMed] [Google Scholar]
  5. Burnell J. M., Dawborn J. K., Epstein R. B., Gutman R. A., Leinbach G. E., Thomas E. D., Volwiler W. Acute hepatic coma treated by cross-circulation or exchange transfusion. N Engl J Med. 1967 Apr 27;276(17):935–943. doi: 10.1056/NEJM196704272761701. [DOI] [PubMed] [Google Scholar]
  6. Condon R. E., Bombeck C. T., Steigmann F. Heterologous bovine liver perfusion therapy of acute hepatic failure. Am J Surg. 1970 Feb;119(2):147–154. doi: 10.1016/0002-9610(70)90026-7. [DOI] [PubMed] [Google Scholar]
  7. Davis M. A., Peters R. L., Redeker A. G., Reynolds T. B. Appraisal of the mortality in acute fulminant viral hepatitis. N Engl J Med. 1968 Jun 6;278(23):1248–1253. doi: 10.1056/NEJM196806062782302. [DOI] [PubMed] [Google Scholar]
  8. Eiseman B., Liem D. S., Raffucci F. Heterologous liver perfusion in treatment of hepatic failure. Ann Surg. 1965 Sep;162(3):329–345. doi: 10.1097/00000658-196509000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hume D. M., Gayle W. E., Jr, Williams G. M. Cross circulation of patients in hepatic coma with baboon partners having human blood. Surg Gynecol Obstet. 1969 Mar;128(3):495–517. [PubMed] [Google Scholar]
  10. Jones E. A., Clain D., Clink H. M., MacGillivray M., Sherlock S. Hepatic coma due to acute hepatic necrosis treated by exchange blood-transfusion. Lancet. 1967 Jul 22;2(7508):169–172. doi: 10.1016/s0140-6736(67)90002-5. [DOI] [PubMed] [Google Scholar]
  11. Parbhoo S. P., James I. M., Ajdukiewicz A., Xanalatos C., Kennedy J., Chalstrey L. J., Brock P. J., Sayer P., Sherlock S. Extracorporeal pig-liver perfusoon in treatment of hepatic coma due to fulminant hepatitis. Lancet. 1971 Apr 3;1(7701):659–665. doi: 10.1016/s0140-6736(71)92678-x. [DOI] [PubMed] [Google Scholar]
  12. Saunders S. J., Terblanche J., Bosman S. C., Harrison G. G., Walls R., Hickman R., Biebuyck J., Dent D., Pearce S., Barnard C. N. Acute hepatic coma treated by cross-circulation with a baboon and by repeated exchange transfusions. Lancet. 1968 Sep 14;2(7568):585–588. doi: 10.1016/s0140-6736(68)90692-2. [DOI] [PubMed] [Google Scholar]
  13. Starzl T. E., Marchioro T. L., Faris T. D., McCardle R. J., Iwaski Y. Avenues of future research in homotransplantation of the liver with particular reference to hepatic supportive procedures, antilymphocyte serum, and tissue typing. Am J Surg. 1966 Sep;112(3):391–400. doi: 10.1016/0002-9610(66)90209-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Summers R. W., Curtis S. J., Hartford C. E., Rubush J. L. Acute hepatic coma treated by cross circulation with irreversibly comatose donor. JAMA. 1970 Dec 28;214(13):2297–2301. [PubMed] [Google Scholar]
  15. Williams R. Treatment of fulminant hepatic failure. Clinical syndrome and basis of therapy. Br Med J. 1971 Jan 23;1(5742):213–215. doi: 10.1136/bmj.1.5742.213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Winch J. Pig liver perfusion and other methods of temporary liver support. Br Med J. 1971 Jan 23;1(5742):216–217. doi: 10.1136/bmj.1.5742.216. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES