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Fulminant hepatitis in patients undergoing liver transplantation: Evidence for a non-A, non-B, non-C, non-D, and non-E syndrome

✍ Scribed by Ferraz, M. Lucia ;Silva, A. Eduardo ;Macdonald, Graeme A. ;Tsarev, Sergei A. ;Di Biscelgie, Adrian M. ;Lucey, Michael R.

Publisher: Wiley (John Wiley & Sons)
Year: 1996
Tongue: English
Weight: 596 KB
Volume: 2
Category: Article
ISSN: 1074-3022
DOI: 10.1002/lt.500020110

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✦ Synopsis

Fulminant hepatic failure (FHF) in the absence of serum markers of hepatitis A (HAV) or B (HBV) infection or another cause is called non-A, non-B (NANB) FHF. The pathogenetic role of viral infection in NANB FHF remains controversial. To better define this relationship, we studied patients who underwent orthotopic liver transplantation (OLT) for FHF. Thirty-six patients with FHF underwent transplantation between 1987 and 1992. Pre-OLT serum was available for 24 patients, 14 with NANB FHF (all female; mean age, 32 years), and 10 (3 males, 7 females; mean age, 20 years) with a defined origin for FHF who formed the control group. Sera were tested using polymerase chain reaction for HAV, HCV, HDV, and HEV RNA and HBV DNA, and also serologically for antibodies to these viruses. In the NANB group, pre-OLT serum was negative for all viruses tested. Four patients ulminant hepatic failure (FHF) is a syndrome in F which massive liver injury or impairment is associated with the rapid development of hepatic encephalopathy. FHF develops as a consequence of toxic injury, viral infection, metabolic disorders, hepatic vascular catastrophes, drug reactions, and neoplastic infiltration. Before the availability of liver transplantation, FHF resulted in death in up to 80% of patients2 Depending on the population studied, between 25% and 40% of patients have no obvious precipitant for fulminant liver fai1u1-e.~ In the absence of serological markers of hepatitis A or B infection or From the

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