Levels and Initial Course of Serum Alanine Aminotransferase Can Predict Outcome of Patients With Budd–Chiari Syndrome

Rautou, Pierre‐Emmanuel; Moucari, Rami; Cazals–Hatem, Dominique; Escolano, Sylvie; Denié, C.; Douarin, Ludivine; Francoz, Claire; Durand, François; Ozenne, Violaine; Imbert, Audrey; Moreau, Richard; Lebrec, Didier; Plessier, Aurélie; Valla, Dominique

doi:10.1016/j.cgh.2009.06.011

Cited by 38 publications

(17 citation statements)

References 26 publications

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“…The peak AST and ALT were also some of the statistically significant predictors of survival in our series, providing a clear marker of the severity and/or acuity of the event. This is consistent with Rautou et al who also found that peak ALT was associated with poor outcomes, supporting the idea that greater ischemia portends worse patient outcomes . Higher peak creatinine level was also observed to be a significant predictor of poor outcome.…”

Section: Discussionsupporting

confidence: 89%

Budd‐chiari syndrome causing acute liver failure: A multicenter case series

et al. 2017

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Background Budd-Chiari syndrome (BCS) is a rare disease resulting from obstruction of the hepatic venous outflow tract that typically presents with abdominal pain, jaundice and ascites without frank liver failure. However, BCS may also evolve more rapidly to acute liver failure (ALF-BCS). Aims To describe the clinical features, treatment and outcomes of ALF due to BCS and compare our results with those in the published literature. Methods Twenty of the 2,300 patients enrolled in the Acute Liver Failure Study Group (ALFSG) registry since 1998, presented with a clinical diagnosis of BCS. An additional 19 cases of ALF-BCS in the English-language literature were reviewed and compared to the ALFSG cases. Results Most ALF-BCS patients were white (84%) and female (84%) in their fourth decade. A hypercoagulable state was noted in 63% of cases. BCS was diagnosed by Doppler ultrasonography or abdominal CT in all cases. Liver biopsies (6) all had evidence of severe peri-central necrosis. Treatments used included most commonly anticoagulation (71%), but also transjugular intrahepatic portosystemic shunt (TIPS) (37%) and orthotopic liver transplantation (37%). In-hospital mortality was approximately 60%. Conclusions Budd-Chiari syndrome is a rare cause of ALF and mandates prompt diagnosis and management for successful outcomes. Once the diagnosis is confirmed, prompt anticoagulation is recommended in conjunction with evaluation for malignancy or thrombophilic disorder. Mortality may have improved in recent years with use of TIPS and/or OLT compared to prior published reports.

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Section: Discussionsupporting

confidence: 89%

Budd‐chiari syndrome causing acute liver failure: A multicenter case series

et al. 2017

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“…Shunt was created via the IVC and right HV in 48 (94.1%) and 3 (5.9%) patients respectively. Bare and covered stents were used in 33 Table S1. The albumin level was significantly higher at the 1-, 3-, 6-, 12-and 24-month follow-up after TIPS procedures than at admission.…”

Section: Tips Proceduresmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt for Budd–Chiari syndrome: techniques, indications and results on 51 Chinese patients from a single centre

Guo

et al. 2013

Liver International

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“…Risk factors for thrombosis were evaluated as reported elsewhere [8,9]. BCS was managed with anticoagulation therapy, radiological interventions [venous angioplasty, transjugular intrahepatic portosystemic shunts (TIPS)], surgical portosystemic shunting, and/or liver transplantation treatment as previously reported [8,9].…”

Section: Patient Managementmentioning

confidence: 99%

“…BCS was managed with anticoagulation therapy, radiological interventions [venous angioplasty, transjugular intrahepatic portosystemic shunts (TIPS)], surgical portosystemic shunting, and/or liver transplantation treatment as previously reported [8,9]. Low-molecular-weight heparin (LMWH) was administered for two weeks beginning on the day of diagnosis, then switched to vitamin K antagonist for long-term anticoagulation therapy, targeting an International Normalized Ratio (INR) ranging from 2 to 3 [6].…”

Section: Patient Managementmentioning

confidence: 99%