Abstract

Orthotropic liver transplantation is currently the treatment of choice for fulminant hepatic failure in Western countries. Most hepatologists in Japan also believe in this view.Liver transplantation, however, is only a symptomatic treatment of liver failure. Fulminant hepatitis, which refers to fulminant hepatic failure, is not a symptom, but a disease entity included in “hepatitis”. Treatment of fulminant hepatitis, therefore, should focus not only on liver failure, but also on the underlying hepatitis. Thus the administration of antivirals and immunosuppressants for viral hepatitis and immunosuppressants for autoimmune and drug-induced hepatitis should be considered.Using this strategy, we have obtained a survival rate of 23/31 (74.1%) [13/17 (76.4%) for the acute type, and 10/14 (71.4%) for the subacute type] in three and a half years.We currently attempt to cure all patients with severe hepatitis by predicting fulminant hepatitis and starting treatment for hepatitis.

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