Liver transplantation for acute hepatic failure: a review of clinical experience and management

OBJECTIVE: The purpose of this review was to examine and describe the clinical experience and outcomes of liver transplantation in humans for acute fulminant hepatic failure. DATA SOURCES: A review of the literature since 1980 using Medline was done to identify clinical reports including case study reports. STUDY SELECTION: Clinical reports were included if they stated the number of patients in a given time frame who were evaluated and/or received a transplant for acute hepatic failure and any other outcome data such as the number of those who recovered without a transplant and who died in the operative period. Twenty-two reports were identified that met the selection criteria. Data were reported inconsistently. No ex post facto reports that examined factors relevant to clinical outcomes were identified. CONCLUSIONS: Acute hepatic failure is considered an acceptable indication for liver transplantation based on the opinions expressed by the leading experts in the field as currently reported in the literature and at professional meetings. Data is limited, however, on outcomes and factors contributing to successful outcomes.