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Research Article

Liver transplantation after paracetamol overdose.

BMJ 1991; 303 doi: (Published 27 July 1991) Cite this as: BMJ 1991;303:221
  1. J G O'Grady,
  2. J Wendon,
  3. K C Tan,
  4. D Potter,
  5. S Cottam,
  6. A T Cohen,
  7. A E Gimson,
  8. R Williams
  1. Institute of Liver Studies, King's College School of Medicine and Dentistry, London.


    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.