1. Fulminant Hepatic Failure Spectrum of etiology and outcome at a tertiary care hospital
Dr Mohit Kehar*
Dr Nishant Wadhwa * *
* Fellow , Division of Pediatric Gastroenterology and Hepatology ,
Institute of Child Health , Sir Ganga Ram Hospital , Delhi
* * Senior Consultant and Chief , Division of Pediatric Gastroenterology , Hepatology
and liver transplantation , Institute of child health , Sir Ganga Ram Hospital , Delhi

2. Introduction
Onset of hepatic encephalopathy in less than eight weeks after the onset of jaundice In the absence of preexisting liver disease Sudden loss of viable hepatic mass

3. Study objectives
To review cases of FHF with regards to patient characteristics, etiology and outcome Center for study : Sir Ganga Ram Hospital Time period : Two year period (Aug July 2012)

4. Methods
The study was a retrospective case record review

5. Results

6. Etiology

7. King’s College criteria

8. Outcome of patients fulfilling King’s college criteria
*Only 2 patients recovered both these patients were suffering
from Acute Hepatitis B infection

9. Outcome of patients fulfilling Kings college criteria
In total 18 patients qualified for Liver Transplant 9 patients’ parents refused due to economic constraints 5 patients had contraindications for Liver transplant Two Severe sepsis one Intracranial bleed one had multiorgan dysfunction Four patients underwent Living related Liver transplantation

10. Liver transplantation for FHF n=4
Total liver transplants performed for FHF 4
Fulminant Wilsons disease 2
Acute viral hepatitis A+E 1
Idiopathic

11. Not Fulfilling King’s Criteria

12. Over all outcome

13. Discussion
Most common cause – Hepatitis A with or without Hepatitis E Nearly one half of the patients qualified for a transplant at the time of presentation Besides medical contraindications, economic factors responsible for few liver transplantations