Background: A 27-year-old woman in her 20th week of pregnancy was hospitalized because of food poisoning caused by Amanita phalloides.

Methods: Previously extracorporeal purification treatments with 2 times of hemodialysis plus hemoperfusion and a high volume therapeutic plasma exchange (PE) in addition to intensive medication during the first 8 days failed to improve hepatic encephalopathy (HE) and liver function but developed deep coma with severe blood chemistry and signs of threatened abortion.

Results: Treatments with intermittent molecular adsorbent recirculating system (MARS) for 3 times resulted in an immediate improvement of liver function and clinical symptoms including HE and threatened abortion until her fully recovery. When the life-threatening maternal illness was cured gestation went on until premature birth at the 36th week of pregnancy, and the infant underwent an undisturbed development.

Conclusion: MARS method appears to be an optimal therapy for patients with acute liver failure secondary to cytoxic mushroom poisoning during pregnancy.

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