[Acute liver failure in a hospital with a liver transplantation program].
BACKGROUND
Acute hepatic failure (AHF) is an uncommon entity but with high mortality. Liver transplantation has improved prognosis but is an aggressive treatment with high risk. Currently, there are no accurate criteria to differentiate between irreversible AHF and the possibility of hepatic regeneration. The aim of this study is to review the clinical characteristics indicating transplantation and the outcome of AHF in patients at our institution.


METHODS
Descriptive and retrospective study of cases of AHF at our institution in the last 3 years.


RESULTS
Eleven patients were studied. Mortality was lower in transplant recipients (23%; 2 out of 8) than in non-transplanted patients (67%; 2 out 3). Hepatic regeneration occurred in one patient. Overall mortality was 36% with a perioperative mortality of 13%.


CONCLUSIONS
The indication of hepatic transplantation in patients with a poor prognosis, early stage acute liver failure, and a low grade of encephalopathy, and prior to the development of multiorgan failure could improve the results of transplantation and reduce perioperative mortality.
Bautista Rodríguez
M D
MD
Servicio de Medicina Intensiva, Hospital Universitario Reina Sofía, Córdoba, Spain. lolabaro@eresmas.com
Pozo Laderas
J C
JC
Bravo-Rodríguez
F de Asís
Fde A
Sánchez-Tembleque
M D
MD
Martos Becerra
J M
JM
Sancho Ruiz
H
H
D000328:Adult; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies