P577 Aims: The overall prognosis for patients with FHF is quite poor without transplantation, with survival rates usually reported between 10% and 30% in relation with the type of clinical presentation. Aim of this study is to evaluate the influence of pretransplant recipient and donor prognostic factors on graft-patient survival. Methods: From April 1986 to June 2003, 796 LT were performed in 696 patients. In the same period, 40 (5,7%) adult patients underwent to first liver transplantation for FHF. The mean age was 32 years (range 17-60); 45% of recipients were male and 55% were female. The coma’s grade was defined by Glasgow Coma Score (GCS) scale. Among the pretransplant recipients variables we analyzed: age, gender, type of FHF, aetiology, time list to LT, Glasgow Coma Score, prothrombin time, AST, ALT, total bilirubin, serum-creatinine, era of transplant, packed red blood cells (PRBC), ischemic period, total operation time, type of surgical procedure (with or without veno-venous by-pass). The following pretransplant donor variables were analyzed too: age, gender, cause of death, ICU stay, ABO match, type of perfusion solution. We used preoperative supportive therapies as bridge to LT by a Bio Artificial Liver (BAL) with porcine cells in one case and by Extra Corporeal Artificial Device with human hepatocytes in another one. The mean patient follow-up time was 41.6 months (range 0-178 months). Results: The indication for transplantation was hyperacute-FHF in 25 cases (62.5%), acute-FHF in 14 (35%), and subacute hepatic failure in one (2.5%). In 52,5%, the aetiology of FHF was virus B infection (21 patients). The other indications were: Amanita Phalloides intoxication in 5 cases, Wilson’s disease in 2, Budd-Chiari Syndrome in one and paracetamol intoxication in another one, in 10 cases (25%) the origin remained unknown. Pre-transplant GCS was <5 in 22 patients (55%) and ≥5 in 18 patients (45%). By far the majority of patients (24/40; 60%) the waiting list time was <48h, while in the remaining 16 patients (40%) it was ≥48h. An identical or compatible graft was used in 87,5% of recipients, while in 12,5% (5/40) a incompatible graft was transplanted. The overall graft survival was 48.3%, 41.1% and 41.1% at 1, 3 and 5 years, respectively, whereas patient survival was 61.3%, 54.6% and 50.4% at 1, 3 and 5 years, respectively. None of the donor parameters analyzed had a significant impact on graft and patient survival. The only recipient variable which had a statistically significant impact on graft survival resulted the waiting list to transplant <48 hours (p=0.05). The overall patient survival resulted slightly influenced by the mean AST level > 1043 U/l, as well as by the mean total operation time >533 minutes. In the incompatible group 4 out of 5 patients lost the graft for acute rejection (3 cases) and PNF (1 case). Conclusions: Liver transplantation remains the better treatment for fulminant hepatic failure. Based on our results the prognostic factors influencing the graft survival is represented by short waiting list time to LT less than 48 hours. Further studies are need to validate extracorporeal support system with either porcine liver cells or non utilized human hepatocytes as a bridge to transplantation.