The different etiology of fulminant hepatic failure (FHF) inKorea and prognostic factors in patients undergoing liver transplantation forFHF

Adult Male Adolescent Liver Failure, Acute Middle Aged Prognosis Liver Transplantation 3. Good health Young Adult 03 medical and health sciences Logistic Models Treatment Outcome 0302 clinical medicine Risk Factors Multivariate Analysis Republic of Korea Humans Female Aged Retrospective Studies
DOI: 10.1111/ctr.12055 Publication Date: 2013-01-01T17:53:02Z
ABSTRACT
AbstractBackgroundThe prognosis of fulminant hepatic failure (FHF) depends on the etiology and reversibility. In this study, we identified the etiological difference ofFHFin Korea and analyzed the prognostic factors after liver transplantation (LT) forFHF.MethodsWe retrospectively reviewed 42 patients withFHFwho underwentLTfromApril 1999 toApril 2011 atSamsungMedicalCenter,Seoul,Korea. The patients were categorized into two groups according to the short‐term result ofLT, and perioperative profiles were compared to identify the short‐term poor prognostic factors.ResultsUnlike Western countries, there was no paracetamol‐relatedFHFbut herbal/folk medicines were the most frequent causes ofFHF(26.2%).HAV‐relatedFHFincreased significantly and comprised the main portion ofFHFwithHerbal/folk medicines after 2005. Encephalopathy grade, onset time, pre‐transplantation need of renal replacement, and ventilator treatment were significantly different between groups in univariate analysis. In multivariate analysis, pre‐transplantation renal replacement treatment and hepatic encephalopathy gradeIVwere the independent prognostic factors afterLT.ConclusionsThe etiologies ofFHFinKorea were different compared withWestern reports. The requirement of renal replacement treatment and hepatic encephalopathy gradeIVwere identified as independent poor prognostic factors afterLTforFHFin this study.
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