Three cases of hepatic coma due to acute hepatitis were treated by exchange transfusion with citrated blood. This was preformed in the first 2 cases (patients No 1 and No 2) after failing to respond to other forms of treatment, and in the last patient, who was admitted to hospital in coma, a few hours after admission. (patient No 3) Two of the 3 patients, patients 1 and 3 recovered, 1 died, (patient No 2) although 2 successive exchange transfusions alleviated coma to some degree