Cadaveric liver transplantation for non-acetaminophen fulminant hepatic failure: a 20-year experience.
OBJECTIVE
To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF).


METHODS
Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo.


RESULTS
One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution.


CONCLUSIONS
Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases.
Detry
Olivier
O
Department of Liver Surgery and Transplantation, University of Liège, CHU Sart Tilman B35, Liège B4000, Belgium. oli.detry@chu.ulg.ac.be
De Roover
Arnaud
A
Coimbra
Carla
C
Delwaide
Jean
J
Hans
Marie-France
MF
Delbouille
Marie-Hélène
MH
Monard
Joseé
J
Joris
Jean
J
Damas
Pierre
P
Belaïche
Jacques
J
Meurisse
Michel
M
Honoré
Pierre
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D017114:Liver Failure, Acute / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life
D018712:Analgesics, Non-Narcotic