Cause and prognosis in acute liver failure

Riordan, Stephen M.; Williams, Roger

doi:10.1002/lt.500050107

Cited by 19 publications

(7 citation statements)

References 33 publications

(49 reference statements)

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“…Despite changes in legislation that may reduce the likelihood of intentional overdose and the potential for effective treatment, a minority of patients develop overt fulminant hepatic failure (FHF) after an intentional overdose or therapeutic misadventure 1–4. Paracetamol (acetaminophen) hepatotoxicity is one of the most common causes of FHF in the United Kingdom, accounting for around 50% of cases 5. Criteria for transplantation in these patients are well described,6, 7 but in the selection of suitable patients, especially in this era of severe donor shortage, we must recognize that many with paracetamol‐associated liver failure will have intentionally self‐harmed.…”

mentioning

confidence: 99%

Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure

et al. 2009

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Paracetamol (acetaminophen) hepatotoxicity, whether due to intentional overdose or therapeutic misadventure, is an indication for liver transplantation in selected cases. However, there is a concern that long-term outcomes may be compromised by associated psychopathology that may predispose patients to further episodes of self-harm or poor treatment adherence. We therefore undertook a retrospective analysis of patients transplanted for paracetamol-induced fulminant hepatic failure (FHF) to determine their long-term outcomes, psychiatric problems, and compliance and whether these issues could be predicted from pretransplant information. Records from patients undergoing liver transplantation for paracetamol-associated liver failure in this unit and 2 comparison groups (patients undergoing liver replacement for FHF from other causes and for chronic liver diseases) were examined. Of 60 patients transplanted for paracetamol-induced FHF between 1989 and 2007, 44 (73%) survived to discharge. Currently, 35 patients (58%) are surviving at an average of 9 years post-transplantation. The incidence of psychiatric disease (principally depression) and 30-day mortality were greatest in the paracetamol group, but for those who survived 30 days, there was no difference in long-term survival rates between the groups. Adherence to follow-up appointments and compliance with immunosuppression were lowest in the paracetamol overdose group. Poor adherence was not predicted by any identifiable premorbid psychiatric conditions. Two patients grafted for paracetamol FHF died from self-harm (1 from suicide and 1 from alcoholic liver disease after 5 years). This study suggests that, notwithstanding the shortage of donor liver grafts, transplantation is an appropriate therapy in selected patients, although close follow-up is indicated. Liver Transpl 15: 1351-1357, 2009.

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confidence: 99%

Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure

et al. 2009

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“…Acute liver failure continues to be associated with a high mortality rate, and emergency liver transplantation is often the only life-saving treatment (Riordan& Williams, 2003). Although, the short-term outcomes are worse in comparison with those for non-urgent cases, due to the initial recovery process, the majority of patients transplanted with acute liver failure, reported that they have a good quality of life (Sargent, 2007;Dobbels, 2010).…”

Section: Acute Liver Diseasementioning

confidence: 99%

Disease Targeted Measures of Health Related Quality of Life (HRQOL) in Patients with Advanced Liver Disease Before and After Liver Transplantation

Taltavull¹,

Peña-Cala²,

Bruzos³

2012

Liver Transplantation - Basic Issues

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“…Besonders schlecht ist die Prognose bei Kindern und älteren Patienten, bei virusinduziertem Leberversagen (mit Ausnahme der Hepatitis A) und bei subakutem Verlauf [15,29].…”

Section: Schlüsselwörterunclassified

“…So spricht man von hyperakutem oder fulminanten Leberversagen, wenn zwischen Beginn der Gelbsucht und Entwicklung der Enzephalopathie weniger als 7 Tage liegen, von akutem Leberversagen bei einem Intervall von 1 bis 4 Wochen und von subakutem bzw. protrahiertem Leberversagen, wenn mehr als 4 Wochen vergangen sind [29].…”

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Extrakorporale Leberunterstützungsverfahren in der Therapie des akuten Leberversagens Eine Standortbestimmung

1999

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The acute liver failure (ALF) is a complex syndrome resulting from loss of synthetic and metabolic functions of the liver. Despite recent advances in intensive care medicine patients with severe ALF have a very high mortality and the orthotopic liver transplantation still remains the only proven effective treatment of ALF. Numerous attempts have been made to improve survival by using various extracorporeal support techniques, but none of these therapeutic approaches was able to increase the survival rate. Liver support systems based on detoxification procedures only could not influence the deleterious course of the disease. It is certain that an ideal liver support system should be capable to fulfil the liver's essential synthetic and metabolic functions as well as detoxification and excretion. Over the last years the development of hybrid liver assist devices has aimed at replacing these liver functions and therefore might give an advantage over earlier systems based on detoxification techniques only. This article gives a short review of the various liver support systems and focuses then on the hybrid liver support systems, their construction and the remaining problems after the first clinical applications.

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Cause and prognosis in acute liver failure

Cited by 19 publications

References 33 publications

Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure

Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure

Disease Targeted Measures of Health Related Quality of Life (HRQOL) in Patients with Advanced Liver Disease Before and After Liver Transplantation

Extrakorporale Leberunterstützungsverfahren in der Therapie des akuten Leberversagens Eine Standortbestimmung

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