[Effect of exchange transfusion on the plasma amino acid concentration in hepatic coma]

Exchange transfusion (ET) were made twice on a 22 year old patient with fulminant hepatitis and hepatic coma. The influence of the ET on the plasma amino acids (PAA) was examined. The 1. ET reduced the concentration of the total PAA from 10,023 to 7,152 mugmol/l (about 28.6%) and the 2. ET from 11,770 to 9,706 mugmol/l (about 17.5%). Three hours after the 1. ET the concentration of the total PAA has passed over the prevalue and after the 2. ET has nearly reached it. The influence of both ET on the concentration of the individual PAA was very different (- 47.9% to + 71.2% after the 1. ET and - 32.9% to + 41.8% after the 2. ET respectively). Therefor the ET seems to be not a suitable method to reduce the pathologic concentration of the PAA in the hepatic coma.