Liver Transplantation for Fulminant Hepatic Failure

Fulminant hepatic failure is the clinical syndrome associated with acute massive necrosis of liver cells. It is characterized by the sudden onset of progressive jaundice, decrease in size of the liver, fetor hepaticus, and hepatic encephalopathy within eight weeks of acute illness. This syndrome carries a mortality rate of more than 80% when the patient develops grand IV hepatic encephalopathy. The depth of encephalopathy is important as an index of the severity of hepatic failure and in the assessment of the prognosis. Other systemic manifestations of fulminant hepatic failure include hypoglycemia, metabolic acidosis, respiratory failure, renal impairment, coagulopathy, and bacteremia.