| [ Summary ] |
In Japan, patients with hepatitis are diagnosed as having fulminant hepatitis when grade II or greater severe hepatic encephalopathy develops within eight weeks of the onset of disease symptoms. These include a prothrombin times of under 40% of the standardized value. Patients with fulminant hepatitis are classified into tow types; those who exhibit the acute and sub acute types, in which encephalopathy occurs the first 10 days and those in whom it occurs 11 days or later after onset of disease symptoms. Also, in this category are patients exhibiting prothrombin times ofless than 40% of the standardized values, with hepatic encephalopathy developing between 8 and 24 weeks of disease onset. These patients are diagnosed as having late onset hepatic failure. Those with out encephalopathy are diagnosed as having acute severe type hepatitis. The diagnosis of these disease types is crucial, since there exist marked differences in the prognoses for patients dependant on the type. The prognosis also differs markedly depending on the etiology of liver diseases such as viral infection, autoimmune hepatitis or drug-induced allergies. The indications for liver transplantationin cases of fulminant hepatitis patients are currently determined according to the guidelines published by the Acute Liver Failure Study Group of Japan in 1996 and/or that of the Intractable Liver Diseases Study Group of Japan in 2008. |