Orthotopic liver transplantation for fulminant and subacute hepatic failure

The fulminant hepatic failure (FHF) is a condition characterized by massive hepatocyte necrosis and one that is associated with severe liver and/or other organ-systems insufficiency leading to death in up to 85 per cent of the cases with medical treatment only. Although various expedients have been tried in order to save these patients, the necrosis is usually so massive that it is beyond regeneration. At present, the only hope lies with orthotopic liver transplantation (OLTx), which has become progressively more successful during the last few years. Various considerations pertaining to OLTx are discussed, as well as our series of 40 patients who were transplanted for FHF, with a survival of 57 per cent.