Living donor liver transplantation for fulminant hepatic failure--medical treatment organization in Kyushu University

Liver transplantation has been recognized as an effective therapeutic method for end-stage liver disease in Japan. Fulminant hepatic failure is also an indication for liver transplantation, and the number of patients undergoing liver transplantation has been increasing. Reversibility and urgency are characteristics of fulminant hepatitis. If given appropriate critical support, many patients recover spontaneously. However, many patients develop cerebral edema or multiorgan failure before the liver can regenerate. From October 1996 to July 2002, living donor liver transplantation (LDLT) was performed to 84 end stage liver disease patients in Kyushu University. Twenty-four (28.6%) of 84 LDLTs were for fulminant hepatic failure. In Kyushu University, LDLT candidates including urgent cases were discussed with indication in the liver transplantation committee (the medical professions division and an outside-the-university committee are included) and then the coordinator committee performs informed consent. LDLT can be performed only by cooperation of each section concerned such as Transfusion part, Medicine part, Radiation part, Operation part, Intensive Care Unit and so on. In this paper, we outline about fulminant hepatic failure and living donor liver transplantation, and describe the fulminant hepatitis medical treatment organization in Kyushu University.