[Personal experience in the treatment of serious hepatic insufficiency]

Personal clinical experience and the results obtained in the treatment of patients suffering from severe hepatic insufficiency observed in the last seven years, out of a total of some 200 cases, are reported. The modalities employed in the application of intensive basic care and special treatment in 50 cases of initial or clear hepatic coma of various aetiological origin are reviewed. Whereas basic treatment involves more purely medical measures, such as reintegrative and nutritional treatment by the venous route, activation of renal function, the prophylaxis of infectious complications and reinfusion of ascitic fluid, that applied to cases of clear coma involves a more properly surgical technique. It makes use of an original biological clarification technique in extracorporeal circulation by means of isolated and perfused heterologous liver, and an isovolaemic exsanguinotransfusion technique. Indications and features are illustrated in detail.