| Theme |
Disease of Liver, Gallbladder, Spleen, and Pancreas in Dialysis Patients |
| Title |
Intensive management in fulminant hepatitis |
| Author |
Eiji Ishikawa |
The First Department of Internal Medicine, School of Medicine, Mie University |
| Author |
Shinsuke Nomura |
The First Department of Internal Medicine, School of Medicine, Mie University |
| Author |
Michiyo Inoue |
The First Department of Internal Medicine, School of Medicine, Mie University |
| Author |
Toshihide Obe |
The First Department of Internal Medicine, School of Medicine, Mie University |
| Author |
Takahiro Ohnishi |
Department of Internal Medicine, Yamada Red Cross Hospital |
| Author |
Yasuhide Mizutani |
Department of Internal Medicine, Yokkaichi Social Insurance Hospital |
| Author |
Takeshi Nakano |
The First Department of Internal Medicine, School of Medicine, Mie University |
| [ Summary ] |
Fulminant hepatitis is a disorder characterized by extreme lethargy for which the survival rate of patients has long been low. A nationwide survey in Japan disclosed that until 1997 the survivals for the subacute type and the acute type of fulminant hepatitis were 10-20% and 40%, respectively. Recently, intensive care consisting of plasma exchange combined with hemodiafiltration has been considered to be effective for the management of fulminant hepatitis. Liver transplantation has also been initiated for the same purpose here in Japan. These aggressive therapies are sometimes called "artificial liver support". As a result of these intensified treatments, the survival rate of patients with fulminant hepatitis has improved with a survey showing the survival rate to now be over 56%.
Although there have been very few cases of fulminant hepatitis among hemodialyzed patients, once it develops the survival rate of these patients is still extremely low. Most of the known cases are considered to be the result of in-hospital infection with hapatitis B virus. This has been due to transfection of such virus of hemodialyzed patients in the hemodialysis center. Therefore, infectious accidents should be avoided. |