Fulminant hepatic failure: observation with serial CT.

Itai, Y; Sekiyama, Kazuhiko; Ahmadi, Tayeb; Obuchi, M; Yoshiba, Makoto

doi:10.1148/radiology.202.2.9015061

Cited by 57 publications

(34 citation statements)

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“…In that respect, the application of preoperative imaging techniques might be of assistance as suggested in 2 studies. 3,14 …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] A multicenter European study, 1 including cases from this institution, showed that 19 (63%) of 30 patients with ALF treated by ALT were alive after a mean follow-up of 18 months, with 13 (68%) of these survivors having regained normal native liver function that allowed permanent withdrawal of immunosuppression. Following ALT, immunosuppression can be withdrawn in a significant proportion of patients.…”

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confidence: 99%

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Auxiliary transplantation for acute liver failure: Histopathological study of native liver regeneration

et al. 2008

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Auxiliary liver transplantation (ALT) permits the serial assessment of regeneration in livers of patients with acute liver failure (ALF). Forty-nine ALF patients [32 adults (median age, 23 years; range, 16-40 years) and 17 children (median age, 12 years; range, 1-15 years)] underwent ALT between 1994 and 2004 at King's College Hospital. Twenty-four patients had seronegative liver failure, 15 had acetaminophen toxicity, 4 had hepatitis B virus (HBV) infection, 3 had drug-induced liver failure, 2 had autoimmune hepatitis, and 1 had mushroom poisoning. Nine patients without post-ALT native liver histology were excluded from review. All acetaminophen-induced, HBV, and drug-related patients had diffuse injury. Twelve seronegative patients and the autoimmune hepatitis patient had a map-like injury. On follow-up, 9 acetaminophen-induced patients, 9 seronegative patients, 2 drug-induced ALF patients, 3 HBV patients, and the autoimmune patient recovered to a near-normal native liver with inconsequential scarring. The hepatocyte proliferative rate in diffuse necrosis was 27.4% (range, 3.1%-69.4%) at hepatectomy and sharply decreased after 8 days post-ALT, being minimal months and years after ALT. In conclusion, in patients undergoing ALT for ALF with a diffuse pattern of liver injury-mainly acetaminophen toxicity-hepatocyte proliferation occurs in the native liver within a few days of transplantation. If the injury is map-like (most cases of seronegative ALF), regeneration seems to involve variable hepatocellular proliferation and potential ductular hepatopoiesis, but sequential assessment is difficult because of sampling variation. The likelihood of histological recovery appears to be minimal in livers with total hepatocyte loss at the time of ALT.

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“…In that respect, the application of preoperative imaging techniques might be of assistance as suggested in 2 studies. 3,14 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Auxiliary transplantation for acute liver failure: Histopathological study of native liver regeneration

et al. 2008

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“…Other prognostic criteria have been proposed including severity of SIRS, 117,118 Alpha fetoprotein (AFP) levels, 172 ratios of factor VIII and factor V, 173 liver histology, 174 CT scanning of the liver, 174,175 cytokine levels, 176 serum phosphate levels, 163,177 and adrenal insufficiency. 178 Evaluations of these criteria have had varied results; while some appear promising, more research is needed to determine their reliability.…”

Section: Prognosismentioning

confidence: 99%

AASLD position paper: The management of acute liver failure

2005

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“…Multiple prognostic models have been proposed to help determine the likelihood of spontaneous survival (Table 2) (Antoniades et al, 2007;Bailey et al, 2003;Bernuau et al, 1986b;Bernuau, 1993;Craig et al, 2010;Harrison et al, 1990;Itai et al, 1997;O'Grady et al, 1989;Pereira et al, 1992;Rolando et al, 2000;Schiodt et al, 2005;Van Thiel, 1993). However, many of these models are methodologically flawed and subject to bias.…”

Section: Prognostic Modelsmentioning

confidence: 99%