FACTORS ASSOCIATED WITH SEVERE INTRACRANIAL HYPERTENSION IN CANDIDATES FOR EMERGENCY LIVER-TRANSPLANTATION

Cerebral edema is the leading cause of death in patients with fulminan t hepatic failure (FHF). Emergency OLT is often a life-saving therapy for FHF but severe cerebral edema is a contraindication to transplanta tion. We attempted to identify clinical and biochemical factors associ ated with the development of severe intracranial hypertension in FHF. Fever, psychomotor agitation, and arterial hypertension were more freq uently observed preceding episodes of severe intracranial hypertension , and more than 50% of FHF patients with uncontrolled intracranial hyp ertension sustained severe brain injury in our series. These observati ons suggest that vigorous treatment of fever, arterial hypertension, a nd agitation are important aspects of the intensive care management of FHF patients to maintain their OLT candidacy.