Liver transplantation etiology

Hepatitis C virus (HCV) is an RNA virus that is a common cause of parenterally acquired viral hepatitis chronic infection follows acute infection in 80% to 85% of cases. Although liver disease resulting from chronic HCV infection is only slowly progressive, HCV is the most common cause of chronic liver disease in the United States, the most common etiology for hepatocellular carcinoma, and the leading indication for liver transplantation [34-36]. 

Prognosis of acute liver failure depends on several factors like etiology of liver disease, age, grade of liver disease, grade of encephalopathy, presence or absence of systemic inflammatory response syndrome, etc. Currently available prognostic scoring systems do not adequately predict outcomes or determine candidacy for liver transplantation (Poison and Lee, 2005). In the smdy of Bhatia et al. (2006), however, three variables were found to be significantly predictive of death arterial ph > 7.40, presence of clinical cerebral edema, and arterial ammonia levels > 124 [imol/1. 

During liver failure, the normal detoxification and synthetic functions of the liver are severely impaired. The liver support device should be able to detoxify and support the synthetic functions of the Uver either to serve as a bridge to liver transplant or permit sufficient liver regeneration so that liver transplantation is not needed. In this regard, the primary purpose of a support device would be to improve overall survival and transplant-free survival. Other possible secondary endpoints include improvements in encephalopathy and renal function, and reductions in measureable toxins and metabolic by-products, including bilirubin, ammonia, urea, and lactate. Ideally, the support device should be effective for both ALF and AOCLF, regardless of etiology. 

Other etiologies Congenital, idiopathic, hereditary (trypsinogen gene mutations), cystic fibrosis, inflammatory bowel disease, peptic ulcer disease, solid organ transplantation (liver, kidney, heart), refeeding... 

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