LIVER-TRANSPLANTATION IN PATIENTS WITH FULMINANT HEPATIC-FAILURE

Fulminant hepatic failure without liver transplantation is associated with a high mortality rate (80-100 per cent). Some 254 liver transplan tations were performed on 202 patients between April 1986 and February 1992. Of these, 26 patients had fulminant hepatic failure. The median age was 31.5 (range 3-60) years. Reduced-size grafts were used in sev en patients. The peroperative mortality rate was six of 26 patients, a nd five patients died during follow-up. Ten patients underwent retrans plantation and two a second retransplant. The overall rate was 16 of 2 6 and actuarial survival rate was 62.7 per cent at 12 months and 48.7 per cent at 36 months. The peroperative mortality rate is relatively h igh but liver transplantation is currently recommended as a last-resor t treatment for patients with fulminant hepatic failure in the absence of response to medical treatment.