title: Transplantation for acute liver failure: report of results in the region of Castilla y Leon (Spain) after 10 years of activity.
abstract: Acute liver failure is an uncommon disease but its overall mortality rate is still high without liver transplantation, which is the treatment of choice for patients achieving certain criteria. We have reported herein the experience and retrospectively analyzed results of liver transplantation for acute liver failure since the beginning of activity of our group, which is the only one in the region of "Castilla y Leon" (Spain). In 10 years, 14 patients underwent emergency transplantation among an overall series of 325 subjects. The patients were generally young men and women; the average wait list time was 2.14 days. The most common etiology was toxic exposure (no cases were related to acetaminophen overdose), followed by viral infection (all because of acute hepatitis B). Our posttransplant outcomes were: perioperative mortality, 0%; posttransplant in-hospital mortality, 14%; and 1-y, 3-y, and 5-year survival rates of 77.1%, 64.3%, and 64.3% respectively. Retransplantation rate was 7%. A major morbidity occurred in four patients: one primary dysfunction, one hyperacute rejection due to ABO blood group-incompatibility requiring retransplantation, two arterial complications, and two biliary leakages. Our outcomes of emergency transplantation were similar to those reported by both the European and Spanish Liver Transplantation Registries, despite the small number of patients.
authors.affiliation: General and Digestive Surgery Department (Liver Transplantation Unit), "Rio Hortega" University Hospital, Valladolid, Spain. mariorodriguezlopez@yahoo.es
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez Lopez
authors.forename: B
authors.initials: B
authors.lastname: Perez Saborido
authors.forename: D
authors.initials: D
authors.lastname: Pacheco Sanchez
authors.forename: E
authors.initials: E
authors.lastname: Asensio Diaz
authors.forename: F
authors.initials: F
authors.lastname: Labarga Rodriguez
authors.forename: R
authors.initials: R
authors.lastname: Martinez Diaz
authors.forename: M
authors.initials: M
authors.lastname: Gonzalo Martin
authors.forename: R
authors.initials: R
authors.lastname: Velasco Lopez
authors.forename: P
authors.initials: P
authors.lastname: Pinto Fuentes
authors.forename: A
authors.initials: A
authors.lastname: Barrera Rebollo
mesh_terms: D000328:Adult; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D017114:Liver Failure, Acute / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult