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The different etiology of fulminant hepatic failure ( FHF ) in K orea and prognostic factors in patients undergoing liver transplantation for FHF
Author(s) -
Kim TaeSeok,
Joh JaeWon,
Moon Hyunghwan,
Lee Sanghoon,
Song Sang Hyun,
Shin Milljae,
Kim Jong Man,
Kwon Choon Hyuck David,
Kim SungJoo,
Lee SukKoo
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12055
Subject(s) - medicine , fulminant hepatic failure , hepatic encephalopathy , etiology , liver transplantation , transplantation , gastroenterology , fulminant , encephalopathy , cirrhosis
Background The prognosis of fulminant hepatic failure ( FHF ) depends on the etiology and reversibility. In this study, we identified the etiological difference of FHF in Korea and analyzed the prognostic factors after liver transplantation ( LT ) for FHF . Methods We retrospectively reviewed 42 patients with FHF who underwent LT from A pril 1999 to A pril 2011 at S amsung M edical C enter, S eoul, K orea. The patients were categorized into two groups according to the short‐term result of LT , and perioperative profiles were compared to identify the short‐term poor prognostic factors. Results Unlike Western countries, there was no paracetamol‐related FHF but herbal/folk medicines were the most frequent causes of FHF (26.2%). HAV ‐related FHF increased significantly and comprised the main portion of FHF with H erbal/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 grade IV were the independent prognostic factors after LT . Conclusions The etiologies of FHF in K orea were different compared with W estern reports. The requirement of renal replacement treatment and hepatic encephalopathy grade IV were identified as independent poor prognostic factors after LT for FHF in this study.