liver transplantation; liver failure; surgery; hepatitis B; liver support
Abstract :
[en] AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo. RESULTS: One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution. CONCLUSION: Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases. (C) 2007 The WJG Press. All rights reserved.
Disciplines :
Gastroenterology & hepatology Anesthesia & intensive care Surgery
Author, co-author :
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
De Roover, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Coimbra Marques, Carla ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Delwaide, Jean ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Hans, Marie-France ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Delbouille, Marie-Hélène ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Monard, Josée ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Joris, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Damas, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation
Belaiche, Jacques ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Meurisse, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Honore, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Language :
English
Title :
Cadaveric liver transplantation for non-acetaminophen fulminant hepatic failure: A 20-year experience
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