Abstract
Of 16 fulminant hepatic failure (FHF) patients treated with charcoal hemoperfusion (HP), 8 (50%) survived. Prior to HP, their serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratios, alpha-fetoprotein (AFP) levels, and prothrombin times were measured. The AST/ALT ratio was significantly higher in the fatal cases (n=8, 1.15±0.24) than in the survivors (n=8, 0.49±0.11) (p＜0.025). The AFP levels in seven patients who survived were greater than 130ng/ml, while seven of eight patients (87.5%) who died had AFP levels of less than 130ng/ml (p=00014). The prothrombin time was significantly more prolonged in the fatal cases (n=5, 29.9±2.9%) than in the survivors (n=8, 47.3±5.8%) (P＜0.05). Neither age, sex, or causal factors affected the prognosis. Charcoal HP did not appear to increase the survival rate in FHF patients with low AFP levels. Serum AFP levels, AST/ALT ratios, and prothrombin times may be useful as prognostic indices in patients with FHF.
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