There are individualized differences in whether skin color will be darkened after blood exchange for liver failure, which should be considered according to the severity of the disease, personal constitution and other comprehensive factors. 1. The severity of the disease: Liver failure is a syndrome in which liver cells are severely damaged due to infection, medication and other reasons, thus disrupting the body’s functions. Clinical symptoms often include fatigue, vomiting and jaundice. When liver function and coagulation function continue to deteriorate after the treatment of yellowing and liver preservation, and there is no sign of improvement, patients with liver failure can be treated with blood exchange. However, when the patient’s liver failure is combined with cirrhosis and other conditions, blood exchange may not have obvious effect, this time may be due to the patient’s liver failure, hormone metabolism abnormalities, melanin increase and the appearance of dark skin. 2. Individual constitution: blood exchange for liver failure generally refers to artificial liver plasma replacement, mainly for severe hepatitis, cirrhosis combined with hyperbilirubinemia and other more serious liver failure patients. If the patient’s physical condition is poor, the condition is serious, and when the blood exchange is still not under control may appear dark skin color due to the continued deterioration of the condition. If darkening of skin color occurs after blood exchange for liver failure, it should be taken seriously and timely medical treatment should be sought.