The purpose of this study is to improve the survival rate of those patients with acute fulminant hepatitis through treatment with the MARS® extra-corporal liver-purification system by:

1. Reducing the number of patients who die before a graft is available
2. Increasing the chances of survival without a liver transplant
3. Reducing the pre- and post-operative mortality in transplant patients

Patients with fulminant or subfulminant hepatitis with either an indication or a relative contraindication to a liver transplantation, are randomized to two groups:

1. A group treated with the conventional medical intensive treatment (including the hemodialysis techniques, continuous veno-venous hemofiltration or hemodiafiltration, if necessary) and the gold standard surgical treatment (liver transplantation) compared to
2. A group receiving, in addition to the conventional medical intensive treatment, albumin dialysis using the MARS device and the gold standard surgical treatment (liver transplantation).

Inclusion Criteria:

• Patients with severe or sub-severe hepatitis, with an indication or a contraindication to liver transplantation

Exclusion Criteria:

• Sepsis severe not controlled
• Haemorrhage activates not controlled
• Clinical Obviousness of disseminated intravascular coagulation
• Severe Pathology cardiopulmonary (NYHA > or = 2)
• Pregnancy, breast feeding
• Average blood Pressure < 40 mmHg more than 10 minutes in spite of a support by the inotrope
• Nonhepatic coma of origin
• Cholestases extra-hepatitic
• Antecedents of heavy surgery in the 4 previous weeks or surgical problems unsolved
• Absolute counter-indication with hepatic transplantation (extra Neoplasia hepatic evolutionary, irreversible cerebral Attack, irreversible multi-visceral Failure, visceral tares contra-indicating the transplantation)
• Positive serology HIV
• Hepatic Demonstrations of the malignant hemopathies
• Participation in another therapeutic test in the 4 previous weeks