The removability for protein-bound toxins of an anion exchange resin (BR-601) was examined comparing with plasma exchange. Six patients with hepatic failure following surgical operation in the hepato-biliary resion were treated with plasma perfusion using BR-601 and plasma exchange (PE). Either BR-601 and PE demonstrated the effect for improvement in coma grade from 3 or 4 to 2 or 3. The initial level of total bilirubin was 15.8mg/dl and it was incerasing rapidly. The removal rates of BR-601 for total bilirubin, direct bilirubin and total bile acids were 26.6 6.6%, 29.5 9.5% and 19.8 9.8%, respectively, showing 80% of relative removability with PE. BR-601 may play one part of removal function in artificial liver support system.