Semin Liver Dis 1989 Aug;9(3):189-94

Fulminant hepatic failure and orthotopic liver transplantation

Schafer DF, Shaw BW Jr
Department of Medicine, University of Nebraska Medical Center, Omaha 68105.

Abstract
Twenty-four patients were transplanted for fulminant hepatic failure at the
University of Nebraska Medical Center from 1986 (July) to 1988. Long-term
survival is about 58%. 2. FHF is an increasingly common indication for liver
transplantation. 3. Cerebral edema, organ availability, and late referral are
obstacles to improved survival. 4. Randomized trials have not been performed to
demonstrate that transplantation is superior toother therapies. For some
etiologies, such as acute Wilson's disease, in which mortality is 100%,
transplantation is clearly indicated. For other etiologies, such as
acetaminophen-induced FHF, in which clear gains in survival have been shown
using more conservative therapies, the decision to transplant patients becomes
more difficult. As all forms of therapy improve, all patients will benefit