Fulminant Hepatic Failure & Liver Transplantation. Fulminant Hepatic Failure. Definition - Altered mental status with coagulopathy in setting of acute liver disease. Hepatic encephalopathy occurring within 8 weeks of onset of illness defines FHF. Viral hepatitis Hepatitis A - rarely
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Definition - Altered mental status with coagulopathy in setting of acute liver disease. Hepatic encephalopathy occurring within 8 weeks of onset of illness defines FHF.
Depressed neural energy metabolism -- but autopsied animals show no changes of ischemia
Decreased hepatic clearance of neuro toxic substances
Signs of increased ICP (may not be present until late)
Consider ICP monitoring if
Get better liver
Get liver better
Renal failure common
Respiratory failure can occur by several mechanisms:
“Authors tend to publish isolated cases with a favorable outcome attributed to a given therapy, but not to publish cases in which therapy has failed. In fact it might be argued that the best future one can wish for a sufferer from SAHF (sudden acute hepatic failure) is to undergo a new treatment and have his case published -- ‘be published or perish!’ “