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Liver transplant for fulminant hepatic failure
D A Campbell1, J M Ham, K R McCurry
1Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0331.
The American Surgeon
|August 11, 1991
Summary
Liver transplantation for fulminant hepatic failure offers excellent outcomes. Selected patients showed comparable survival and recovery, demonstrating its viability as a treatment option.
Area of Science:
- Hepatology
- Transplantation Surgery
- Critical Care Medicine
Background:
- Fulminant hepatic failure (FHF) presents significant challenges for liver transplantation due to multi-organ failure, neurological issues, and coagulopathy.
- Orthotopic liver transplantation (OLT) is a complex procedure with inherent risks, especially in critically ill patients.
Purpose of the Study:
- To evaluate the outcomes of emergent orthotopic liver transplantation in patients with fulminant hepatic failure.
- To compare the results of OLT for FHF with those for other liver transplant indications.
Main Methods:
- Retrospective analysis of 16 patients who underwent emergent OLT for FHF at the University of Michigan.
- Assessment of patient survival, intra-operative resource utilization, and neurological recovery.
Main Results:
- Patient survival at 2 years was 68.2%, comparable to other OLT indications.
- Intra-operative blood product use and surgery duration were similar to non-FHF transplant recipients.
- All patients achieved complete recovery from preoperative neurological abnormalities.
- Recurrent viral hepatitis was observed but did not lead to allograft loss.
Conclusions:
- Emergent orthotopic liver transplantation is an effective therapy for selected patients with fulminant hepatic failure.
- OLT can provide excellent outcomes, including neurological recovery, despite the complexities of FHF.