Prise en charge des hépatites aiguës jusqu'Ã la transplantation hépatique

Fulminant hepatitis is a rare affection with severe outcome without liver transplantation. Identification of the etiologic factors is urgently requested in an aim to apply the adequate therapy, and to manage the patient within a specialized hepatology reanimation unit in close contact with a liver transplantation centre. Prognosis factors should be defined as early as possible and liver transplantation performed as necessary. Complications are rather common, especially sepsis, and an accurate monitoring is mandatory in a specific “organ-system” approach. Unfortunately fulminant hepatitis frequently leads towards a fatal outcome while awaiting liver transplantation, mainly due to a critical lack of liver grafts. Innovative approaches are under development and/or evaluation, such as living donor liver grafts, cryopreserved hepatocyte transplantation and bioartificial liver systems.