A case Report of Fulminant Hepatic Failure in a Renal Transplant Recipient

A230 Introduction: FHF is a medical emergency. All patients with FHF must be considered as potential transplant candidates and be transferred to a transplant centre early. Methods: Retrospective review of hospital records of all children referred to the liver transplant unit at Red Cross Children’s Hospital with fulminant hepatic failure (FHF) from 1991-2004. Results: 25 patients were referred for liver transplant (LTx) over the 14 year period. All children fitted the Kings College criteria for FHF. There were 16 female and 9 male patients. Their ages ranged from 1.8-13 years. FHF was caused by Hepatitis A in 8 patients (30%), Hepatitis B in 1 (%), by toxins/drugs in 4 (20%) and of indeterminate cause in 12 (50%) of children. 22 patients were accepted for LTx. 2 patients were rejected on social grounds and 1 for medical reasons. 10 patients received a cadaver LTx, 12 patients died awaiting LTx. 4 children received 1 or more exchange transfusions but none were transplanted or survived. Of the 10 children who were transplanted, 6 have survived (mean follow up 46 months (range 4-120)) and 4 have died. 1 child was retransplanted and 2 received complete blood group mismatch grafts. Conclusions: 13% (10/78) of all liver transplants done at this unit presented with FHF. None of them were living related transplants. Donor shortage led to a high mortality (55 %) of children awaiting transplantation. Long term good quality survival can be achieved despite use of ABO blood group incompatible organs. 2 of the 4 children who died post LTx were adolescents who had been non-compliant with their immunosuppression.

Fulminant hepatic failure

Economic shortage

Fulminant

Liver disease

10.1097/00007890-200407271-01957

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Effect of Liver Transplantation in Children with Fulminant Hepatitis

Clinical and Experimental Pediatrics (2000)

서영미 최보화 김경모 박광민 이영주

Fulminant hepatitis

Fulminant

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Rapid progression of encephalopathy in a patient with hepatitis B infection.

PubMed (2007)

Nobuyuki Takemura Yasuhiko Sugawara Sumihito Tamura Junichi Kakeno Yuichi Matsui

The mortality rate of fulminant hepatic failure was high until liver transplantation was presented as a potential therapy. We encountered a patient with hyperacute fulminant hepatic failure due to hepatitis B virus infection. Living donor liver transplantation was planned but abandoned because her brain edema progressed too rapidly to complete the donor evaluation. The present case reveals the limitation of living donor liver transplantation as a treatment for hyperacute fulminant hepatic failure.

Fulminant hepatic failure

Hepatic Encephalopathy

Fulminant

Fulminant hepatitis

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Liver transplantation in a patient with sickle cell disease and fulminant hepatic failure

Hepatology (1993)

Dinesh Ranjan

Fulminant hepatic failure

Fulminant

Liver disease

10.1016/0270-9139(93)92889-8

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