Abstract: Objective: To observe the efficacy and safety of artificial liver plasma exchange in treatment of chronic severe hepatitis B.Methods: Forty cases of chronic severe hepatitis B were randomly divided into treatment group and control group.Both groups were given comprehensive medical treatment,and the patients in treatment group were administered liver plasma exchange therapy.The clinical manifestation before and after treatment,the main laboratory indicators and the adverse reactions of the patients receiving liver plasma exchange therapy were compared.The short and long term effects were evaluated according to the survival rate during the 3-12 months' follow-up.Results: The symptoms of the 20 cases receiving liver plasma exchange therapy improved significantly;alanine aminotransferase,aspartate aminotransferase,total bilirubin and creatinine decreased (P<0.01),and prothrombin activity increased (P<0.01);only 3 of the 40 cases presented adverse reactions (7.5%);the survival rate was 70.0%,which was higher than that of 35.0% in the control group (P<0.05).Conclusions: Artificial liver plasma exchange is safe and effective for treatment of chronic severe hepatitis B.