Am J Surg 1987 Jul;154(1):137-41

Fulminant hepatic failure: the role of liver transplantation as primary therapy

Brems JJ, Hiatt JR, Ramming KP, Quinones-Baldrich WJ, Busuttil RW

Abstract
Fulminant hepatic failure is a clinical syndrome with a high mortality rate when
traditional supportive therapy is used as treatment. Orthotopic liver
transplantation has been proposed as a therapeutic option. Clinical and logistic
difficulties include the rapid deterioration of the patients, unpredictable
recovery, and the immediate need for a donor organs. Including this series, a
total of 41 patients with fulminant hepatic failure have been transplanted, with
a survival rate of 61 percent. We have reported eight liver transplantations
carried out in six patients. Four of the patients survived (66 percent). Death
was due to irreversible neurologic dysfunction in one patient and fungal sepsis
in one patient. These results indicate that orthotopic liver transplantation is
a practical therapeutic option for fulminant hepatic failure which should be
considered early, before neurologic deterioration becomes irreversible