Liver transplantation in fulminant hepatic failure: experience with 40 adult patients over a 17-year period

Transplant Proc. 2005 Mar;37(2):1085-7. doi: 10.1016/j.transproceed.2004.12.225.

Abstract

Introduction: To evaluate the influence of pretransplantation recipient and donor prognostic factors on graft-patient survival.

Materials and methods: Between April 1986 and June 2003, 40 liver transplantation (LT) procedures to treat fulminant hepatic failure were performed (5.7%). Twenty-one pre-LT recipient and donor variables were retrospectively considered for analysis.

Results: The indications for LT were hyperacute (62.5%), acute (35%), and subacute hepatic failure (2.5%). Glasgow Coma Scale scores ranged from <5 in 22 patients to > or =5 in 18 patients. The causes were hepatitis B (n = 21), unknown (n = 10), Amanita phalloides (n = 5), and other (n = 4). The 1-year graft and patient survival rates were 48.3% and 61.3%, respectively. Perioperative and late mortality was 27.5% and 22.5%. The only variable statistically significant for graft survival was waiting list time for LT <48 hours (P = .05).

Discussion: Liver transplantation is the best treatment for fulminant hepatic failure, with a 1-year patient survival rate of 61.3%. The short waiting list time has an important role in outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Graft Survival*
  • Humans
  • Liver Failure, Acute / surgery*
  • Liver Transplantation / mortality
  • Liver Transplantation / physiology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome