FULMINANT HEPATIC-FAILURE - PATHOPHYSIOLOGY, TREATMENT, AND SURVIVAL

Fulminant hepatic failure is characterized by severe metabolic derange ments, neurologic complications and, ultimately, multiorgan failure. i n the past three decades, improved intensive care has increased mean s urvival from 15% to 50% in certain patient groups by providing metabol ic support and management of specific, frequent, and potentially fatal complications. However, outcome remains highly dependent on etiology. While intensive care is sufficient therapy in some patients (Group I) , those with irreparable hepatic damage (Group III) can only survive i f transplanted. In intermediate cases (Group II), the liver retains th e potential to regenerate if the patient receives hepatic functional s upport. Major areas of current research in this field include developm ent of hepatic support devices, strategies to accelerate and maximize hepatic regeneration, and criteria for accurate prognostic classificat ion of patients.