Acute liver failure: spontaneous recovery or transplantation?
BACKGROUND
Decision-making in acute liver failure. Acute liver failure is a disease with multiple organ involvement and a high mortality rate. Conservative management alone will only partly influence the outcome. The option of emergency liver transplantation has greatly improved survival rates, but unables spontaneous recovery. A set of prognostic criteria enables selection of patients who will benefit the most from emergency liver transplantation.


METHODS
Retrospective review and survey of the Groningen results.


RESULTS
Of 52 patients (33 adults and 19 children) admitted for acute liver failure 2 were beyond recovery and died, 9 were treated conservatively and recovered and 41 were listed for emergency liver transplantation because of an estimated survival rate < 20%. Of these, 3 died and 1 recovered spontaneously while waiting and 37 were transplanted. Survival rate for 41 patients listed for transplantation was 23 (56%) and was similar for children and adults.


CONCLUSIONS
In patients with acute liver failure, management and decision-making in a specialized liver unit with the possibility of emergency liver transplantation is mandatory.
Meerman
L
L
Division of Gastroenterology, University Hospital Groningen, The Netherlands.
Zijlstra
J G
JG
Schweizer
J J
JJ
Verwer
R
R
Slooff
M J
MJ
Haagsma
E B
EB
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D006801:Humans; D007223:Infant; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate