title: The different etiology of fulminant hepatic failure (FHF) in Korea and prognostic factors in patients undergoing liver transplantation for FHF.
abstract: BACKGROUND
  The prognosis of fulminant hepatic failure (FHF) depends on the etiology and reversibility. In this study, we identified the etiological difference of FHF in Korea and analyzed the prognostic factors after liver transplantation (LT) for FHF.
  
  
  METHODS
  We retrospectively reviewed 42 patients with FHF who underwent LT from April 1999 to April 2011 at Samsung Medical Center, Seoul, Korea. The patients were categorized into two groups according to the short-term result of LT, and perioperative profiles were compared to identify the short-term poor prognostic factors.
  
  
  RESULTS
  Unlike Western countries, there was no paracetamol-related FHF but herbal/folk medicines were the most frequent causes of FHF (26.2%). HAV-related FHF increased significantly and comprised the main portion of FHF with Herbal/folk medicines after 2005. Encephalopathy grade, onset time, pre-transplantation need of renal replacement, and ventilator treatment were significantly different between groups in univariate analysis. In multivariate analysis, pre-transplantation renal replacement treatment and hepatic encephalopathy grade IV were the independent prognostic factors after LT.
  
  
  CONCLUSIONS
  The etiologies of FHF in Korea were different compared with Western reports. The requirement of renal replacement treatment and hepatic encephalopathy grade IV were identified as independent poor prognostic factors after LT for FHF in this study.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Kim
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.forename: Hyunghwan
authors.initials: H
authors.lastname: Moon
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Lee
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Song
authors.forename: Milljae
authors.initials: M
authors.lastname: Shin
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Choon Hyuck David
authors.initials: CH
authors.lastname: Kwon
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult