M. Sterneck et al., TRANSPLANTATION OF COMPLETE AND SPLIT LIVER GRAFTS FOR PATIENTS WITH FULMINANT HEPATIC-FAILURE, Zeitschrift fur Gastroenterologie, 34(12), 1996, pp. 795-800
Fulminant hepatic failure is associated with considerable mortality un
der conservative management. The aim of this study was to assess appli
cability and outcome of liver transplantation using cadaveric and livi
ng donated grafts in patients with fulminant hepatic failure. 42 patie
nts presenting with fulminant hepatic failure between 1988 and 1995 we
re retrospectively analyzed. 37 (88%) met the indication criteria for
liver transplantation. 22 patients underwent orthotopic liver transpla
ntation, one patient auxiliary orthotopic liver transplantation. Actua
l survival rate of these patients is 74% after a mean follow-up of 23
(3-68) months, 38% (14/37) of the patients with an indication for tran
splantation did not receive a cadaveric graft due to scarcity of cadav
eric organs (n = 9), medical contraindications (n = 3) or spontaneous
recuperation (n = 2). Only 21% (3/14) of these patients survived. Due
to unavailability of a cadaveric organ four patients, six months to 22
years of age, underwent living related liver transplantation as a las
t possible treat ment option. Three of them died from cerebral herniat
ion. It is concluded that transplantation of a cadaveric graft increas
ed survival rate from 21% to 74% in patients with an indication for li
ver transplantation. Living related liver transplantation as an indivi
dual rescue therapy had no favourable outcome.