Liver Transplantation for Fulminant Hepatic Failule

Jung, J G; Park, K M; Lee, Y J; Hwang, S; Kim, K H; Ann, C S; Lee, S G

Abstract

BACKGROUND/AIMS: Basically the liver transplantation for fulminant hepatic failure(FHF) requires timely donor, but the conventional cadaveric donor liver transplantation(CDLT) has the limitation in this regard. The purpose of this study is to evaluate the efficacy of living donor liver transplantation (LDLT) for FHF.
METHODS
Among the 359 OLTs in a single center, from Aug. 1992 to Dec. 2000, 23 recipients(6.4 %) were transplanted for FHF : Two from the cadaveric donor (2/359, 0.56 %), twenty one from the living donor (21/359, 5.85 %). Among the 21 LDLT, 9 were child, 12 were adult LDLT. The grafts used for adult to adult LDLT were mostly right lobe(10/12, 83.3 %). The medical records of these FHF recipients were retrospectively analysed. RESULT: The causes of original diseases were ; two wilson's disease, nine cryptogenic liver cirrhosis and twelve drug intoxications. Encephalopathy grade were 3 for grade II, 14 for grade III and 6 for grade IV. The seventeen out of twenty three FHF patients (74%) were survived after their liver transplatation. Despite the very low graft to body weight ratio (GBWR), the fifteen LDLTs for FHFs survived with timely high quality living donor liver transplantation.
CONCLUSION
Based on these preliminary data, we believe that the LDLT should be considered as primary option for FHF not only for child but also for adult patients.