title: Fulminant hepatic failure: outcome after listing for highly urgent liver transplantation-12 years experience in the nordic countries.
abstract: Fulminant hepatic failure is a common indication for liver transplantation. Outcomes of patients listed for a highly urgent liver transplantation have been studied, with special emphasis on etiology of the liver disease, clinical condition, and ABO blood type. Data have been collected from the Nordic Liver Transplantation Registry. All Nordic patients listed for a highly urgent primary liver transplantation during a 12-year period have been included. Of the 315 patients listed for a highly urgent liver transplantation, 229 (73%) received a first liver allograft, 50 patients (16%) died without transplantation, and 36 patients (11%) were permanently withdrawn and survived. In 43% of the patients, no definite etiology of the liver failure could be established. Paracetamol intoxication was the most frequent specific indication for listing. Patients with blood type A had no significant shorter waiting time (3.8 v 6.6 days; P =.1) but a higher rate of transplantation (82% v 66%, P =.006) as compared with blood type O patients. In a multivariate analysis, paracetamol intoxication remained the single independent predictor of an outcome without transplantation. In conclusion, a high transplantation rate was observed among patients listed for a highly urgent liver transplantation because of fulminant hepatic failure. Blood type O patients had a lower chance of receiving a liver allograft. Patients with paracetamol intoxication had both a higher mortality without transplantation and a higher withdrawal rate attributable to improved condition.
authors.affiliation: Department of Medicine, Rikshospitalet, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Brandsaeter
authors.forename: Krister
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: Styrbjörn
authors.initials: S
authors.lastname: Friman
authors.forename: Bo-Göran
authors.initials: BG
authors.lastname: Ericzon
authors.forename: Preben
authors.initials: P
authors.lastname: Kirkegaard
authors.forename: Helena
authors.initials: H
authors.lastname: Isoniemi
authors.forename: Michael
authors.initials: M
authors.lastname: Olausson
authors.forename: Ulrika
authors.initials: U
authors.lastname: Broome
authors.forename: Lars
authors.initials: L
authors.lastname: Schmidt
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.forename: Kristian
authors.initials: K
authors.lastname: Bjøro
mesh_terms: D000017:ABO Blood-Group System; D000082:Acetaminophen / Q000506:poisoning; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D005544:Forecasting; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries; D016019:Survival Analysis; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000017:ABO Blood-Group System; D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen