Acute liver failure surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Liver transplantation remains the only definitive therapy in patients of acute liver failure who fail to regenerate liver tissue to maintain life. Whole organ liver transplantation (deceased liver) or living donor liver transplantation(LDLT) can also be opted.[1]
Surgery
- Drainage of ascites
- While many people who develop acute liver failure recover with supportive treatment, liver transplantation is often required in people who continue to deteriorate or have adverse prognostic factors.
- "Liver dialysis" (various measures to replace normal liver function) is evolving as a treatment modality and is gradually being introduced in the care of patients with liver failure.
Liver Transplantation
The King's College criteria were described in a publication in 1989 by J.G. O'Grady and colleagues. The criteria were stratified into acetaminophen and non-acetaminophen causes of acute liver failure, due to the different operating characteristics of parameters correlating with prognosis in the two causes.
King's College Hospital criteria for liver transplantation in acute liver failure[2] |
Patients with paracetamol toxicity pH <7.3 or |
Other patients Prothrombin time >100 seconds or |
References
- ↑ Ostapowicz G, Fontana RJ, Schiødt FV, Larson A, Davern TJ, Han SH, McCashland TM, Shakil AO, Hay JE, Hynan L, Crippin JS, Blei AT, Samuel G, Reisch J, Lee WM (2002). "Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States". Annals of Internal Medicine. 137 (12): 947–54. PMID 12484709. Retrieved 2012-10-26. Unknown parameter
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ignored (help) - ↑ O'Grady JG, Alexander GJ, Hayllar KM, Williams R (1989). "Early indicators of prognosis in fulminant hepatic failure". Gastroenterology. 97 (2): 439–45. PMID 2490426.