Abstract
FULMINANT HEPATIC FAILURE (FHF) overall survival rate is usually ,20%. At least in certain etiologic categories, however, up to 60% of patients survive without transplantation. Similar figures (1-year survival between 56 and 80%) are currently reported in several series after hepatic grafting. The possibility of an early prediction on which patients have little hope of recovery would be of great help in the correct therapeutic management of the disease by identifying early those patients who need transplantation. When the graft is not available, these patients could be selected for “hazardous” liver assistance procedures, and if the procedure has certain benefits, this is more likely to be recognized if it is applied only to patients with a high probability of dying with conventional treatment alone. On the contrary, in the group of patients with concrete possibilities of spontaneous recovery, liver transplantation may represent a significant overtreatment. At present, however, there is no consensus on the prediction of outcome in FHF. Clinical indicators still remain the most important parameters for assessment of prognosis in patients with FHF. The purpose of the present study was to define a score capable of distinguishing early between patients who will recover with a conservative medical support and those who will not.
Published Version
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