Liver transplantation after paracetamol overdose.
British Medical Journal 1991; 303 doi: https://doi.org/10.1136/bmj.303.6796.221 (Published 27 July 1991) Cite this as: British Medical Journal 1991;303:221- J G O'Grady,
- J Wendon,
- K C Tan,
- D Potter,
- S Cottam,
- A T Cohen,
- A E Gimson,
- R Williams
Abstract
OBJECTIVE--To evaluate the role of liver transplantation after paracetamol overdose. DESIGN--Prospective study of consecutive candidates for transplantation and performance of transplantation over 18 months. SETTING--Liver unit, King's College Hospital, London. MAIN OUTCOME MEASURES--Fulfilment of indicators of poor prognosis, selection for transplantation, transplantation, survival. RESULTS--30 of 37 patients considered to have a reasonable prognosis with intensive medical care survived. Of 14 of 29 patients considered to have a very poor prognosis and registered for urgent liver transplantation, six received liver transplants, four of whom survived, while seven died and one survived without a transplant. Three of 15 patients with poor prognostic indicators but not selected for transplantation survived. CONCLUSION--Liver transplantation will have a definite but limited role in the management of fulminant hepatic failure induced by paracetamol.