Hepatology 1984 Jan-Feb;4(1 Suppl):22S-24S

An assessment of orthotopic liver transplantation in acute liver failure

Williams R, Gimson AE

Abstract
Mortality of fulminant hepatic failure with standard supportive therapy is high
(80 to 85%), but unfortunately most patients present to hospital already in
Grade IV encephalopathy with severe liver dysfunction, and many have secondary
organ damage. If seen earlier, during Grade III encephalopathy, recent
experience with charcoal hemoperfusion can give good results (65% survival).
Transplantation has a place in those patients who do not respond, and in cases
with early Grade IV encephalopathy. Transplantation should also be considered in
patients with subacute hepatic failure in whom mortality is equally high and
progression to cirrhosis may occur in those who recover. In both groups, the
ability to correct the hemorrhagic diathesis and an adequate supply of donor
organs are essential to achievement of a successful transplant at this critical
time