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BRAZILIAN SINGLE CENTER SURVIVAL RATES AFTER LIVER TRANSPLANT DUE TO FULMINANT HEPATIC FAILURE

BRAZILIAN SINGLE CENTER SURVIVAL RATES AFTER LIVER TRANSPLANT DUE TO FULMINANT HEPATIC FAILURE Andre I. David, Maria Paula V.Coelho, Sergio P. Meira Filho, Marcio D. De Almeida, Bianca Della-Guardia, Marcelo B. Rezende, Rogerio C. Afonso, Ben-Hur Ferraz-Neto

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BRAZILIAN SINGLE CENTER SURVIVAL RATES AFTER LIVER TRANSPLANT DUE TO FULMINANT HEPATIC FAILURE

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  1. BRAZILIAN SINGLE CENTER SURVIVAL RATES AFTER LIVER TRANSPLANT DUE TO FULMINANT HEPATIC FAILURE Andre I. David, Maria Paula V.Coelho, Sergio P. Meira Filho, Marcio D. De Almeida, Bianca Della-Guardia, Marcelo B. Rezende, Rogerio C. Afonso, Ben-Hur Ferraz-Neto Transplant, Hospital Israelita Albert Einstein, Sao Paulo, SP, BrazilBackground: Fulminant hepatic failure (FHF) represents 5% of liver failure in UNOS-Data and 17.4% in our program. FHF are prioritized for a liver graft, but donors are a critical issue (7.0 donors/million).This high risk situation could compromise results. Purpose: analyze results of liver transplant (OLT) for FHF within the last 3 years.Casuistic and Methods: Retrospectively were analyzed twenty six patients transplanted from May 2005 to September 2008 in a single center.Results: Donor characteristics (medians): age 40.5 years, 42.3% with 1 vasopressor, 38.5% with >1 vasopressors, BMI was 24.0 kg/m2, sodium 155 mEq/l, ALT 39 U/L, AST 53.5 U/L, cardiac arrest 42.3 % and controlled infection 19%. Causes of death: 42.3% cerebral bleeding, 38.5% cranioencephalic trauma, 3.8% ischemic cerebral vascular accident and 11.5% others. Grafts characteristics: 73.1% grade 1 liver steatosis, 19.2% grade 2, 3.8% had grade 3. Arterial anomalies in 19.2%, median cold and warm ischemia time: 452.5 minutes and 54 minutes. Recipient's characteristics (medians): age: 44 years, intra-operatory time: 400 minutes, intra-operatory blood transfusion: 2 red blood packages, ICU stay: 11 days after transplant, length of hospital stay: 19.5 days. Three recipients (11.5%) needed retransplant. Five patients (19.2%) died post OLT. One year graft and patient survival rate was 73,08% and 82,61% respectively. Survival curve from State of Sao Paulo, shows 55,36% and 58,8%, respectively for grafts and patients.ConclusionLiver transplant has satisfactory survival rates in FHF in specialized center. References • O’Grady JG; Schalmp SW; Williams R. Acute hepatic failure: redefining syndromes. Lancet, 342: 273-5, 1993. • Sass, DA; Shakil, AO. Fulminant Hepatic Failure.. Liver Transplantation, 11, (6): 594-605, 2005. • http://www.ustransplant.org • http://www.abto.org.br

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