Difficult management problems in fulminant hepatic failure.

The management of each FHF patient offers valuable opportunities to learn about the disease process, but the severity of this illness leaves little room for mishaps or omissions. FHF is a true medical emergency, like cardiogenic shock or acute renal failure. Hepatologists and transplant surgeons should train and teach their team, including ICU staff and house officers, in the basic aspects of FHF management. Furthermore, we strongly favor the creation of "FHF groups" in transplantation centers frequently caring for FHF patients. This group brings together hepatologists, transplant surgeons, ICU staff, nurses, neurologists, transplant coordinators, social workers, and others to design an FHF management protocol, periodically update and refine it, and develop a local consensus on the management of the many issues surrounding the care of the patient with FHF.