 In patients developing liver failure , a liver transplant is often the only option to prevent death . Liver transplants have become a well @-@ established option in amatoxin poisoning . This is a complicated issue , however , as transplants themselves may have significant complications and mortality ; patients require long @-@ term immunosuppression to maintain the transplant . That being the case , the criteria have been reassessed , such as onset of symptoms , prothrombin time ( PTT ) , serum bilirubin , and presence of encephalopathy , for determining at what point a transplant becomes necessary for survival . Evidence suggests , although survival rates have improved with modern medical treatment , in patients with moderate to severe poisoning , up to half of those who did recover suffered permanent liver damage . A follow @-@ up study has shown most survivors recover completely without any sequelae if treated within 36 hours of mushroom ingestion . 
