[Acute liver failure: current hepatological-surgical therapy strategies]

Abstract

Patients with acute liver failure, characterized by deep jaundice, hepatic encephalopathy within eight weeks from the start of symptoms, are subjected to intensive care treatment. New drugs (Interferons, Prostaglandins) have been applied to these patients, with variable results. Mortality of fulminant hepatic failure is high in patients who don't respond to intensive therapy. These patients are characterized by progressive hepatic encephalopathy, decrease of clotting factors, especially of factor 5 and constantly increased serum bilirubin. Results of a multivariate analysis disclosed a poor prognosis in the individual patient more then 40 years old or under 11 years, with a prothrombin time below 10% of control, serum bilirubin over 300 mmol/l and with a late onset of hepatic encephalopathy after long standing jaundice.