Good outcome of living donor liver transplantation in drug‐induced acute liver failure: A single‐center experience

Choudhary, Narendra S.; Saigal, Sanjiv; Saraf, Neeraj; Rastogi, Amit; Goja, Sanjay; Bhangui, Prashant; Vohra, Vijay; Govil, Deepak; Soin, Arvinder S.

doi:10.1111/ctr.12907

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…A summary of recent publications from tertiary care centers in India is shown in Table 4. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] During epidemics of viral hepatitis,~1% of clinical cases may develop ALF. The various etiologies of ALF include hepatitis virus infections (the most common cause in India), drugs such as anti-TB therapy (ATT) drugs, metabolic causes, ischemia, and toxins.…”

Section: Disease Burdenmentioning

confidence: 99%

“…The geographical and age-related heterogeneities are highlighted in Table 6. 35,38,[60][61][62][63][64][65] It is apparent that HAV infection in adults leading to ALF has progressively increased during the past three decades from 1.7% to very high in some reports.…”

Section: Hepatitis Amentioning

confidence: 99%

“…Paracetamol toxicity leading to ALF constitutes nearly half of all causes of ALF in the West, 101 while in India, it constitutes~1% of all causes of drug-induced ALF. 102 Idiosyncratic druginduced liver injury constitutes around 11% of all ALFs in the USA with antibacterials, antituberculosis agents, herbal and dietary supplements, antiepileptics, and nonsteroidal antiifammatory drugs, as top 5 causes . 101 In India, anti-TB drugs, antiepileptic drugs (first generation), sulfonamides, and antiretroviral drugs are the most common drug classes causing drug-induced ALF.…”

Section: Drug-induced Liver Injurymentioning

confidence: 99%

“…117 The exact incidence of ALF in the developing world and in pregnancy is unknown; however, a large number of studies from India have shown that the occurrence of ALF in pregnancy is more common than that in general population. 24,26,38,51,72 This is likely due to higher incidence of HEV infection in pregnancy and also certain pregnancy-specific conditions such as acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome causing ALF in the third trimester of pregnancy. 118 It has been postulated that physiological stress coupled with poor nutrition of pregnant females in our country causes increased susceptibility to viral infections.…”

Section: Alf During Pregnancymentioning

confidence: 99%

“…HEV infection contributes to more than half cases of icteric hepatitis in the pregnant population, while its prevalence in pregnant women with ALF is 60-90%. 26,38,51,72 Other viral infections causing ALF in pregnancy include HBV, HAV, and rarely HSV and VZV. The other causes of ALF in pregnancy reflect similar trends as in the general population with some pregnancyspecific causes to be made a note of.…”

Section: Alf During Pregnancymentioning

confidence: 99%

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Indian National Association for the Study of the Liver Consensus Statement on Acute Liver Failure (Part 1): Epidemiology, Pathogenesis, Presentation and Prognosis

Anand

Nandi²,

Acharya

et al. 2020

Journal of Clinical and Experimental Hepatology

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Acute liver failure (ALF) is an infrequent, unpredictable, potentially fatal complication of acute liver injury (ALI) consequent to varied etiologies. Etiologies of ALF as reported in the literature have regional differences, which affects the clinical presentation and natural course. In this part of the consensus article designed to reflect the clinical practices in India, disease burden, epidemiology, clinical presentation, monitoring, and prognostication have been discussed. In India, viral hepatitis is the most frequent cause of ALF, with drug-induced hepatitis due to antituberculosis drugs being the second most frequent cause. The clinical presentation of ALF is characterized by jaundice, coagulopathy, and encephalopathy. It is important to differentiate ALF from other causes of liver failure, including acute on chronic liver failure, subacute liver failure, as well as certain tropical infections which can mimic this presentation. The disease often has a fulminant clinical course with high short-term mortality. Death is usually attributable to cerebral complications, infections, and resultant multiorgan failure. Timely liver transplantation (LT) can change the outcome, and hence, it is vital to provide intensive care to patients until LT can be arranged. It is equally important to assess prognosis to select patients who are suitable for LT. Several prognostic scores have been proposed, and their comparisons show that indigenously developed dynamic scores have an edge over scores described from the Western world. Management of ALF will be described in part 2 of this document.

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