Clinical course of cirrhosis in young adults and therapeutic potential of liver transplantation.

The lack of information on survival in young adults with cirrhosis and the increasing use of liver transplantation in this age group have led us to carry out a retrospective analysis of the clinical course and survival in 83 young adults aged between 15 and 30 years presenting to the Liver Unit between 1970 and 1983. Fifty four (65%) patients had cirrhosis at initial presentation and in the remaining 29 (35%) this developed within the study period. The overall five year survival of the group, excluding 14 cases treated by transplantation, was 70%. When considered according to aetiological groups this was 83% in those with chronic active hepatitis, 60% in those with cryptogenic cirrhosis and 37% in Wilson's disease. When considered in relation to Child's grading, only three deaths occurred in the 45 patients with well-compensated liver disease (Child's grade A and B). Of the 38 patients with Child's grade C, 20 (83%) of the 24 patients not undergoing transplantation have died, whereas eight (57%) of the 14 receiving liver grafts are alive and well.