The role of liver transplantation in 29 patients with fulminant and subacute hepatic failure due to a variety of different causes was examined by comparing the outcome and a variety of "hospitalization" variables. Transplanted patients (n = 13) were more likely to survive (p < 0.05), were younger (p < 0.05) and spent more time in the hospital (p < 0.025) than did those who were not transplanted (n = 16). Despite spending a much longer time in the hospital, transplanted patients spent less time in the intensive care unit (p < 0.05) in coma (p < 0.01) and on a respirator (p < 0.01) than did those not transplanted. Most importantly, the survival rate for transplanted patients was significantly improved (p < 0.05)
as compared to those not transplanted. We conclude that liver transplantation can be applied successfully to the difficult clinical problem of fulminant and subacute hepatic failure.
Fulminant and subacute hepatic failure are major clinical problems in hepatology because of the uniformly poor prognosis experienced by its victims. Most series report mortality figures ranging between 80 to 100% with the majority reporting survival rates of only 5 to A wide variety of experimental modalities have been used in an effort to improve the dismal prognosis of such patients. These include charcoal and other resin hemoperfusion systems, total body blood exchange techniques, temporary liver support using animal organs connected in series with the patient and heterotopic liver transplantation (7-15). As yet, none of these methods has provided consistent results. Moreover, in most hands, the results with these modalities have been little or no better than standard medical care provided in an intensive care unit.
Since February, 1981 until July 1, 1985, we have been referred for consideration for orthotopic hepatic transplantation (OLTx) 29 adult patients with acute or subacute hepatic failure. Herein, we report our experience with these patients.
10% (1-6).