Fulminant Hepatic Failure.

The initial approach to a patient with fulminant hepatic failure includes assessment of the grade of encephalopathy and the cause of hepatic failure. Aggressive supportive therapy with early referral to a transplantation center is recommended for patients with advancing encephalopathy. A critical component of the transplant decision process is the ongoing clinical assessment of reversibility of neurologic status; liver transplantation continues to be the only successful intervention in patients with advanced encephalopathy. Emerging therapies such as auxiliary transplantation and extracorporeal liver assist devices are being perfected or rigorously evaluated.