Summary
In 2 patients with post-hepatitic acute hepatic necrosis, a complex coagulation defect
characterized by low levels of prothrombin, factor V, and factor IX, hypofibrinogenemia,
thrombocytopenia, and pathologic thrombin time was present. Levels of factor VIII
were abnormally elevated. Exchange blood transfusions led to striking but shortlasting
improvement in coagulation and were found to be an efficient means in control of bleeding.
Extracorporal perfusion of the livers of pigs, and of a human liver raised the levels
of the liver-synthesized clotting factors prothrombin, factor V, and factor IX in
the patient’s blood. Increase of fibrinogen level occurred solely after 36 h perfusion
of a human liver. Adverse effects of extracorporeal liver perfusion were decrease
of platelets, fibrinogen, and factor VIII.