LT, Others : O-070 ; The different etiology of Fulminant Hepatic Failure in Korea and prognostic factors in patients underwent liver transplantation for Fulminant Hepatic Failure = LT, Others : O-070 ; The different etiology of Fulminant Hepatic Failure in Korea and prognostic factors in patients underwent liver transplantation for Fulminant Hepatic Failure

다국어 초록 (Multilingual Abstract)

Background: The prognosis of FHF depends on the etiology and reversibility. Although the King’s College Hospital (KCH) criteria and Clichy/Villejuif criteria remain the most widely used prognostic criteria of FHF, there are also limitations due to geographically various and different causes of disease. Furthermore it is difficult to estimate prognosis after liver transplantation (LT) according to these criteria. Therefore, we identified the etiologic difference of FHF in Korea, and analyzed the prognostic factors after LT for FHF. Methods: We retrospectively reviewed medical records of 42 patients diagnosed with FHF and underwent LT from April 1999 to April 2011 at Samsung Medical Center, Seoul, Korea. We evaluated the etiologic change and difference compared with western countries. The patients were categorized into two groups according to the in-hospital result of LT; survival group (n=35) and mortality group (n=7). Perioperative profiles were compared between groups to identify the in-hospital poor prognostic factors after LT for FHF. Results: The most common cause of FHF underwent LT was toxic hepatitis (45.2%). Unlike western countries, there was no paracetamol-related FHF but herbal medication or folk remedies are the most frequent causes of toxic hepatitis (58%). There was no patient underwent LT due to HAV-related FHF until 2005, however HAV-related FHF increased significantly and comprised the main portion of FHF (34.5%) after 2005. Encephalopathy grade, onset time, pre-transplantation need of renal replacement and ventilator treatment were significant prognostic factors after LT for FHF in univariate analysis. In multivariate analysis, pre-transplantation renal replacement treatment was the independent prognostic factor after LT for FHF. Conclusions: In this study, we showed the different etiology of FHF in Korea and identified the renal replacement treatment as an independent prognostic factor after LT for FHF. In order to confirm the prognostic factors after LT for FHF, large size of studies are needed.