Williams R, Gimson A E
Hepatology. 1984 Jan-Feb;4(1 Suppl):22S-24S. doi: 10.1002/hep.1840040708.
Mortality of fulminant hepatic failure with standard supportive therapy is high (80 to 85%), but unfortunately most patients present to hospital already in Grade IV encephalopathy with severe liver dysfunction, and many have secondary organ damage. If seen earlier, during Grade III encephalopathy, recent experience with charcoal hemoperfusion can give good results (65% survival). Transplantation has a place in those patients who do not respond, and in cases with early Grade IV encephalopathy. Transplantation should also be considered in patients with subacute hepatic failure in whom mortality is equally high and progression to cirrhosis may occur in those who recover. In both groups, the ability to correct the hemorrhagic diathesis and an adequate supply of donor organs are essential to achievement of a successful transplant at this critical time.
暴发性肝衰竭采用标准支持治疗时死亡率很高（80%至85%），但不幸的是，大多数患者入院时已处于IV级肝性脑病且伴有严重肝功能不全，许多患者还存在继发性器官损害。如果在III级肝性脑病阶段更早发现，近期木炭血液灌流的经验可取得良好效果（生存率65%）。对于无反应的患者以及早期IV级肝性脑病患者，肝移植是一种选择。亚急性肝衰竭患者的死亡率同样很高，康复者可能会进展为肝硬化，此类患者也应考虑肝移植。在这两组患者中，纠正出血素质的能力和充足的供体器官供应对于在此关键时期成功进行移植至关重要。
