[Criteria for and results of liver transplantation in patients with acute liver insufficiency].

OBJECTIVE

Evaluation of the results of emergency liver transplantation in patients with acute liver failure.

DESIGN

Analysis of 25 patients with acute liver failure.

SETTING

University Hospital Rotterdam Dijkzigt.

METHOD

Twenty-five patients with acute liver failure were admitted to the Intensive Care Unit in January 1989-May 1993. Patients were selected for emergency liver transplantation according to the Clichy criteria (presence of confusion or coma and factor V activity less than 20-30%).

RESULTS

Liver transplantation was indicated in 17 patients and performed in 13. The 1-year survival rate in patients with a liver transplant was 85%. Four patients with an indication for liver transplantation, but who could not be transplanted died. All 8 patients without an indication for emergency liver transplantation survived.

CONCLUSION

Survival after liver transplantation for acute hepatic failure is now about 80%; the Clichy criteria appear to be helpful in selecting patients with acute hepatic failure for liver transplantation.