Acute liver failure in Turkey: A systematic review

Abstract

Background/Aims: To present the causes of acute liver failure in Turkey. Materials and Methods: International and national medical research databanks were searched for publications related to acute liver failure and originating from Turkey. Patients in the databank of acute liver failure of our center were also added to this literature search. Patients were evaluated for age, gender, etiology, treatment modality, and outcomes. Results: A total of 308 patients were analyzed. Hepatitis A (20.9%) for children and hepatitis B (34.7%) for adults were the most common causes of acute liver failure. Cryptogenic (18%) and metabolic (14%) reasons were the followings. Wilson's disease was the most common cause of metabolic diseases. Mushroom intoxication was the most frequent factor of toxic liver failure for both adults and children (13%). Firework intoxication, including yellow phosphorus, is an indigenous factor. Anti-tuberculosis agents (3.2%) were the main cause of drug-induced acute liver failures (9%). Paracetamol was responsible for only 0.7% of all acute liver failures. Survival of the transplanted patients (n=118) was better than the non-transplanted patients (n=178) (65% vs. 36% respectively, p<0.001) Conclusion: Preventable causes of acute liver failure in Turkey include hepatitis viruses and intoxication. Active vaccination and public awareness can decrease the number of acute liver failures. Paracetamol is not an emerging reason for acute liver failure in Turkey now, but selling it over the counter may increase the risks.

Changes in acute viral hepatitis epidemiology in the Turkish adult population: A multicenter study

“…The most common cause of this disease is viral hepatitis developing into fulminant hepatitis; among these cases, the most frequently seen microorganisms are HAV in children and HBV in adults (17). Fulminant hepatitis develops at a prevalence rate of 0.1% to 0.4% in acute HBV cases (18).…”

Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center’s experience in Turkey

“…Mushroom poisoning was the most common toxic cause of ALF in our study. A systematic review reported that mushroom intoxication was the most frequent factor of toxic liver failure for both adults and children (13%) in Turkey (9). This can lead to ALF with high mortality, which is likely due to late presentation (27).…”

“…However, the cause of ALF still remains undetermined in a large proportion of children (5). Some centers with and without liver transplantation (LT) facilities in Turkey have reported their experience of the etiology of ALF in childhood (6)(7)(8)(9).…”

A Importância da Referenciação Precoce na Falência Hepática Aguda Pediátrica

“…1,5,6 As causas variam consoante a idade e área geográfica ou nível Revista Científica da Ordem dos Médicos www.actamedicaportuguesa.com Jerónimo M, et al Referenciação precoce na falência hepática aguda pediátrica, Acta Med Port 2015 Sep-Oct;28(5):559-566 socioeconómico da região. 2,5,7 O seu tratamento constitui um desafio para os profissionais de saúde. Combina a abordagem inicial de uma doença rapidamente progressiva com envolvimento multiorgânico e a necessidade urgente de decidir manter apenas a terapêutica médica de suporte ou avançar para um transplante hepático (TRH) urgente.…”