Liver transplantation for fulminant hepatic failure in the pediatric patient.

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Abstract
ACUTE OR fulminant hepatic failure (FHF), defined as massive liver necrosis with encephalopathy developing within 8 weeks from the first sign of illness in a patient without underlying chronic liver disease, is one of the most dramatic and challenging syndromes in clinical medicine. While FHF is a relatively rare condition in the pediatric patient population, it is frequently fatal in the absence of liver replacement. Causes of FHF in the pediatric patient include infectious agents, drugs and toxins, inherited metabolic disorders, infiltrative disease, autoimmune hepatitis, and ischemic or irradiation damage. A proportion of the cases are cryptogenic. The etiology with most metabolic disorders differs depending on the age of the child, while some specific infectious agents predominate in the neonatal period or in infancy (age 1