Fulminant hepatitis: Treatment or management?

In conclusion, the mechanisms leading to extensive acute hepatic damage in some patients and, specifically, the factors determining hepatic encephalopathy are unknown. This lack of knowledge has thus far precluded the development of specific therapy for this serious disease. The various attempts at treatment have been supported by unproved hypotheses, and progress in survial during the last 30 years can readily be explained by improvement in intensive care management alone. Any further progress will probably result from a better definition of the mechanisms involved in liver necrosis, the development of cytoprotective substances, the characterization of hepatotropic factors, and the development of more efficient artificial liver support systems.