Fulminant Hepatitis and Liver Transplantation

López, Angel; Jerez, Vicente; Rebollo, Jesus; Lombardo, Ana G.; Julia, Jose A.

doi:10.7326/0003-4819-108-5-769_1

Cited by 8 publications

(2 citation statements)

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“…The indication of liver transplantation for fulminant hepatic failure has been described previously (Lopez et al 1988;Lorber 1988;Takahashi et al 1994;Zhu et al 2002). The group of King's college hospital advocated a classification based on the paracetanol toxicity (Ogrady et al 1989).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding fulminant hepatitis, the survival is reported to be better if patients undergo LRLT compared with conventional medical therapy (Zhu et al 2002). However, in rapidly progressive cases, in which hepatic function completely starves within a few days, it is difficult to perform liver transplantation because of insufficient time for preparing liver donation (Lopez et al 1988;Lorber 1988). Moreover, even if liver transplantation is performed, irreversible neurological damages due to brain edema may remain (Kadono et al 2001).…”

Section: Casementioning

confidence: 99%

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Living Related Liver Transplantation for Acute Fulminant Hepatitis B: Experience from Two Possible Hyper-Acute Cases

Inoue

Ueno

Kanno

et al. 2005

Tohoku J. Exp. Med.

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Fulminant hepatic failure, which is represented by fulminant hepatitis, is fatal in most cases unless prompt liver transplantation is performed. Even if liver transplantation is performed, irreversible neurological damage is often complicated. In this case report, we describe two cases of fulminant hepatitis induced by acute hepatitis B virus infection, both of which were successfully rescued by living related liver transplantation without significant complications. The case 1 was a 45-year-old Japanese male. He complained general malaise and anorexia. His local physician diagnosed him as acute hepatitis B, and referred to our hospital. Due to severe coagulopathy, plasma exchange was performed 3 times. However, his hepatic coma progressed rapidly along with rapid decrease of both his direct/indirect bilirubin (D/T) ratio and serum blood urea nitrogen (BUN) levels. Living related liver transplantation was performed under the diagnosis of acute fulminant hepatitis B. The case 2 was a 34-year-old Japanese male. His complaints were fever and skin rush. He was referred to our hospital under the diagnosis of acute hepatitis B. On the second day after admission, he developed grade II hepatic coma, which deteriorated into grade III in spite of intensive therapy including plasma exchange. He also demonstrated rapid decrease of both D/T ratio and serum BUN level. Living related liver transplantation was performed on the next day. Both cases recovered without any evidence of neurological sequelae. In general, it is extremely difficult to rescue fulminant hepatitis by conservative treatments, particularly in cases with rapid progression. Although emergency liver transplantation may be an only option to rescue in such a case, living related liver transplantation has an advantage in view of urgent organ donation over cadeveric transplantation. fulminant hepatitis; living related liver transplantation

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Section: Discussionmentioning

confidence: 99%