Fulminant hepatic failure: etiology and indications for liver transplantation.
Fulminant hepatic failure is characterized by the development of severe liver injury with impaired synthetic capacity and encephalopathy in patients with previous normal liver or at least well compensated liver disease. The etiology of fulminant hepatic failure refers to a wide variety of causes, of which toxin-induced or viral hepatitis are most common. In spite of specific therapeutic options in distinctive etiologies, orthotopic liver transplantation is the only therapy proven to improve patient survival in the majority of patients. The outcome is determined by the complications like severe coagulopathy, infections, renal impairment or increased intracranial pressure. The decision for transplantation depends on the possibility of spontaneous hepatic recovery, which may be estimated by several factors. The most important variables for predicting the need of transplantation in fulminant hepatic failure are the degree of encephalopathy, patients age and the underlying cause of liver failure.
Gotthardt
Daniel
D
Department of Internal Medicine IV, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Daniel_Gotthardt@med.uni-heidelberg.de
Riediger
Carina
C
Weiss
Karl Heinz
KH
Encke
Jens
J
Schemmer
Peter
P
Schmidt
Jan
J
Sauer
Peter
P
D000293:Adolescent; D000328:Adult; D002648:Child; D005355:Fibrosis / Q000628:therapy; D006505:Hepatitis / Q000473:pathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000139:chemically induced; D017114:Liver Failure, Acute / Q000209:etiology* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008875:Middle Aged; D009398:Nephrology / Q000379:methods*; D011379:Prognosis; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome