An Effective Treatment of Fulminant Hepatic Failure: A Single-Center Retrospective Study

Objectives: Fulminant hepatic failure is a critical condition with a high mortality rate. Currently, liver transplantation is considered one of the most effective treatment methods, but the shortage of organ resources has presented a major obstacle. The use of marginal donor livers, including those from syphilis- positive donors, offers new opportunities. This study reviewed and analyzed data from our center to summarize the management experience of using syphilis-positive donor livers to treat fulminant hepatic failure. Materials and Methods: From January 2016 to December 2021, 17 adult patients with fulminant hepatic failure received liver transplants from syphilis-positive donors at our center. Given the imbalance in several baseline variables, propensity score matching was used. We compared outcomes, including complications, hospital stay, recovery of liver function, and survival rates between groups of patients with syphilis-positive and syphilis-negative grafts. We also reviewed treatment of recipients of syphilis-positive livers. Results: No significant differences were shown in complications and hospital stays between recipients of syphilis-positive and syphilis-negative grafts. Both groups showed similar trends in liver function recovery. Patient and graft survival rates were comparable between the groups. Benzathine penicillin effectively protected recipients from syphilis. Conclusions: Use of liver grafts from syphilis-positive donors did not increase morbidity and mortality in recipients. Liver transplant can effectively treat patients with fulminant hepatic failure. In addition, prophylactic use of benzathine penicillin was beneficial.