Hemodialysis versus cross hemodialysis in experimental hepatic coma

In this study, the effects of conventional hemodialysis on experimental hepatic coma have been compared with those of hemodialysis against blood from a normal donor which allows exchanges without mixing of blood. cuprophan and polyacrylonitrile membranes were compared. Cross hemodialysis with a donor resulted in rpompt but transient recovery of consciousness, whichever membrane was used. Cuprophan hemodialysis without donor had no effect. Polacrylonitrile hemodialysis without donor allowed progressive and prolonged improvement in the consciusness level and the electroencephalograms. Therefore, clearance of middle molecular weight substances was more effective than exchange with a donor. Preliminary results in man showed total recovery of consciousness in six of ten patients with acute liver failure and coma and partial recovery from complete grade IV coma to grade II encephalopathy in two patients. These two patients reacted when called by their name by opening their eyes and obeying simple orders.