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Semin Liver Dis 1996; 16(4): 415-425
DOI: 10.1055/s-2007-1007254
ORIGINAL ARTICLE

© 1996 by Thieme Medical Publishers, Inc.

Liver Transplantation in Europe for Patients with Acute Liver Failure

Henri Bismuth, Didier Samuel, Denis Castaing, Roger Williams1 , Stephen P. Pereira
  • Centre Hépatobiliare, Hôpital Paul Brousse, Faculty of Medicine Paris Sud Villejuif, France, Institute of Liver Studies, School of Medicine and Dentistry, King's College Hospital, London, United Kingdom
  • 1Institute of Hepatology, University College London Medical School, London, United Kingdom
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Publication History

Publication Date:
17 March 2008 (online)

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ABSTRACT

Approximately 11% of all liver transplants performed in Europe are for acute liver failure, with one-year patient survival rates ranging between 50% and 75%. This review summarizes the selection, perioperative management, and outcome of patients transplanted for acute liver failure, with particular reference to the experience at the Hôpital Paul Brousse in Paris and at King's College Hospital, London. In both centers, the decision to proceed to liver transplantation is based on criteria that predict a survival of less than 20% with medical management alone. Infectious complications and cerebral edema remain the most common causes of death, and highlight the importance of intensive monitoring and early treatment of perioperative complications. In selected patients, auxiliary partial orthotopic liver transplantation may be a therapeutic option, with the potential for native liver generation and eventual immunosuppression withdrawal in approximately two-thirds of patients.

KEY WORDS

auxiliary liver transplantation - cerebral edema - fulminant hepatic failure - hepatectomy

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