Abstract: Objective To study the efficacy of plasma exchange (PE) plus hemodiafiltration (HF) in the treatment of increased intracranial pressure in pig model of acute liver failure. Methods Ten minipigs were randomly enrolled into two groups: control group (n=5) and treatment group (n=5).ALF was induced by administration of D-galactosamine (dosage: 1.2g/kg). After 24 and 48 hours the treatment group were treated with PE combined with HF,while the control group were not treated. Intracranial pressure(ICP) was monitored continuously.And the liver function，serum tumor necrosis factor (TNF-a), interleulin-1(IL-1), interleulin-6(IL-6)，endotoxin，nitric oxide (NO)，middle molecule substances (MMS)and survival time were observed. Results After treating with artificial liver support system,the liver functions of the treatment group were ameliorated(P＜0.05～0.01).The intracranial hypertension and biochemical parameters decreased obviously(P＜0.05～0.01). The treatment group's mean survival time was （125.7±12.6）hours, which was longer than the control group[(58.9±11.2) hours]. Conclusions PE plus HF may significantly decrease the levels of pathologic components, ameliorate liver function,decrease intracranial pressure and prolong the survial time. PE plus HF were effective in treatment of patients with acute liver failure.

Key words: Plasma exchange, Hemodiafiltration, Acute liver failure, Intracranial pressure