Objective  To retrospectively analyse the efficacy and the influencing factors of plasma exchange (PE) in patients with chronic severe hepatitis.   Methods  Sixty patients of chronic severe hepatitis were included.   Results  The effective rate was 61.7%. The efficacy of PE was closely related to age

clinical stage

pre-treatment serum bilirubin values

prothrombin activity and incidence of complications (P0.01). No significant correlation was observed between the efficacy and the treatment frequency of PE (P0.05).   Conclusion  PE can significantly improve the survival of patients with chronic severe hepatitis. Especially for the patients under 60 years old

those with low serum TBIL level and high PTA

and those in the early clinical stage

PE treatment would achieve a better efficacy. But the improvement of prognosis of severe hepatitis still depends on the early specific treatment and active prevention of complications.