title: Liver transplantation for acute liver failure: analysis of applicability.
abstract: BACKGROUND
  Liver transplantation has emerged as the most important advance in the therapy of acute liver failure. To assess the applicability of liver transplantation in this setting, the outcome of 62 patients with acute liver failure consecutively admitted to hospital was analyzed.
  
  
  METHODS
  Criteria for indicating liver transplantation were grade III-IV hepatic encephalopathy or progression of encephalopathy following a transient improvement. In subfulminant cases, liver transplantation was also indicated when no improvement was observed after a 3-day period of conservative treatment.
  
  
  RESULTS
  Thirteen (21%) of the 62 patients never met criteria for transplant indication; all of them were discharged after receiving conventional therapy. Twenty-one (34%) patients with criteria for indicating liver transplantation could not receive the transplant because of either contraindications (17 patients; only 1 being discharged from hospital) or death before donor organ availability (4 patients). Finally, 28 (45%) patients received a liver transplant and 22 were discharged from hospital.
  
  
  CONCLUSIONS
  The applicability of liver transplantation in acute liver failure is relatively low. Considering the high survival rate (79%) obtained in the patients with transplantations and the poor survival rate (6%) observed in those who could not be transplanted, efforts should be made to increase liver transplant applicability to improve the prognosis in acute liver failure.
authors.affiliation: Liver Unit, Hospital Clínic i Provincial, University of Barcelona, Catalunya, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Castells
authors.forename: J M
authors.initials: JM
authors.lastname: Salmerón
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: A
authors.initials: A
authors.lastname: Rimola
authors.forename: J
authors.initials: J
authors.lastname: Saló
authors.forename: H
authors.initials: H
authors.lastname: Andreu
authors.forename: A
authors.initials: A
authors.lastname: Mas
authors.forename: J
authors.initials: J
authors.lastname: Rodés
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome