One hundred eighty-one consecutive patients with fulminant hepatic failure (FHF) presenting
in a 2-year period were reviewed. In this cohort we examined the impact of pretransplant
renal failure on mortality and morbidity following orthotopic liver transplantation (OLTx).
Twenty-seven patients (18 female, 9 male) with a median age of 43.5 years (range 19–65
years) underwent OLTx. FHF was due to idiosyncratic drug reaction (n= 4), paracetamol
overdose (n= 3), seronegative hepatitis (n= 17), hepatitis B (n= 1), veno-occlusive disease …

In conclusion, the availability of liver transplantation has dramatically advanced the
management of fulminant hepatic failure. A major responsibility of the gastroenterologist/
hepatologist involved in the care of patients with liver failure is early decision making
regarding likelihood of spontaneous recovery and consideration toward referral to a
transplantation center. In particular, patients with exposure to drugs or toxins (other than
acetaminophen); patients with presumed non-A, non-B hepatitis; children or older patients; …