title: Liver transplantation due to fulminant hepatic failure.
abstract: OBJECTIVE
  To analyze the epidemiology, causes, complications, and mortality of liver transplants following fulminant hepatic failure over the last 16 years.
  
  
  METHODS
  We completed a descriptive analysis of 21 patients with fulminant hepatic failure and a liver transplant. In almost half of the cases, the origin of liver failure was unknown.
  
  
  RESULTS
  The mean age was 36 years; the study group was 47.61% female (n = 10) and 52.39% male (n = 11). The most common early complication was transplant rejection, which occurred in 33.3% of all patients (n = 7) and was confirmed by liver biopsy; the most frequent long-term complication was autoimmune hepatitis. Two retransplantations were necessary. The total mortality rate was 38.1% (n = 8) with late mortality in three patients (14.3%).
  
  
  CONCLUSIONS
  Orthotopic liver transplantation as a treatment for fulminant hepatitis has a higher mortality rate than orthotopic liver transplantation due to other causes. It does, however, enable the survival of 62% of the patients who otherwise would have died due to liver failure. The etiology of most of the cases was unknown. We should point out the high incidence rates for transplant rejection and late autoimmune hepatitis, in addition to the possibility of hemorrhagic colonic diseases that may be associated with the condition causing liver failure. Multidisciplinary control over the patient is useful for deciding at which time a liver transplant would become the only treatment option.
authors.affiliation: General and Gastrointestinal Surgery Department, Hospital Universitario Virgen del Rocío, Seville, Spain. virgichiclana@hotmail.com
authors.forename: V
authors.initials: V
authors.lastname: Gómez Cabeza de Vaca
authors.forename: C
authors.initials: C
authors.lastname: Bernal Bellido
authors.forename: J N
authors.initials: JN
authors.lastname: Alamo Martínez
authors.forename: G
authors.initials: G
authors.lastname: Suárez Artacho
authors.forename: L M
authors.initials: LM
authors.lastname: Marín Gómez
authors.forename: J
authors.initials: J
authors.lastname: Serrano Díaz-Canedo
authors.forename: F J
authors.initials: FJ
authors.lastname: Padillo Ruiz
authors.forename: M A
authors.initials: MA
authors.lastname: Gómez Bravo
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male