Role of Liver Transplantation in Acute Liver Failure

Liou, Iris; Larson, Anne M.

doi:10.1055/s-2008-1073119

Cited by 62 publications

(44 citation statements)

References 156 publications

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“…LT is indicated in patients with fulminant hepatic failure related to HBV reactivation without alternative therapy and in the absence of contraindications [19,20]. However, HBV-related fulminant hepatic failure in patients with CML or other chronic hematologic malignancies is extremely unusual, and the role of transplantation in these cases is still unknown.…”

Section: Discussionmentioning

confidence: 97%

Chronic myeloid leukemia patient manifesting fatal hepatitis B virus reactivation during treatment with imatinib rescued by liver transplantation: case report and literature review

et al. 2009

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Imatinib mesylate (imatinib) is now a standard treatment for patients with chronic myeloid leukemia (CML). Although imatinib is known to have a potential impact on various infectious organisms by altering the T-cell mediated immune response, only two cases of hepatitis B virus (HBV) reactivation during imatinib treatment have actually been reported. The role of liver transplantation (LT) after fatal HBV reactivation in patients with potentially treatable or curable hematologic malignancy is also unknown. Therefore, this report presents a case of fatal HBV reactivation during imatinib treatment for CML, where the patient is rescued by LT. Following a successful living donor LT, the liver function improves rapidly and the patient remains in complete cytogenetic remission after retreatment with imatinib for 6 months. The present report also covers the role of tyrosine kinase inhibitor in triggering HBV reactivation and a literature review of fulminant hepatic failure in CML patients taking imatinib.

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Section: Discussionmentioning

confidence: 97%

Chronic myeloid leukemia patient manifesting fatal hepatitis B virus reactivation during treatment with imatinib rescued by liver transplantation: case report and literature review

et al. 2009

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“…Hepatic coma grade and prothrombin activity have been accepted as major prognostic factors for ALF (16). In the present study, hepatic coma grade at the diagnosis of ALF with hepatic coma was deteriorated with the increase of SIRS score.…”

Section: Discussionmentioning

confidence: 53%

SIRS Score Reflects Clinical Features of Non-Acetaminophen-Related Acute Liver Failure with Hepatic Coma

et al. 2012

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Objective In acetaminophen-induced acute liver failure (ALF), the hepatic coma grade worsens and mortality rates increase, as the number of systemic inflammatory response syndrome components fulfilled (SIRS score) increases. This study aimed to investigate the impact of SIRS score on clinical features of nonacetaminophen-related ALF. Methods Ninety-nine patients with non-acetaminophen-related ALF with hepatic coma who did not undergo liver transplantation were investigated. Each patient was given a SIRS score of 0, 1, 2, 3 or 4 at the time of diagnosis. Results At the diagnosis of ALF with hepatic coma, with the increase of SIRS score, hepatic coma grade and prothrombin activity were deteriorated. After the diagnosis of ALF with hepatic coma, 25 patients (25%) developed acute respiratory distress syndrome (ARDS), 31 patients (31%) developed disseminated intravascular coagulation (DIC), and 21 patients (22%) developed acute renal failure (ARF). Thirty-eight patients (38%) developed MOF. With the increase of SIRS score, frequencies of the development of ARDS, DIC and MOF increased. ARF was more frequently developed in patients with a SIRS score of 2 or higher. Overall, 36 patients (36%) survived. Overall survival rate was 66% in 29 patients with a score of 0, 43% in 21 patients with a score of 1, 17% in 29 patients with a score of 2 and 15% in 20 patients with a score of 3 or 4. Conclusion SIRS score will be useful for predicting not only the overall survival but also the development of complications such as ARDS, DIC and MOF in non-acetaminophen-related ALF with hepatic coma.

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“…Devido à falta de órgãos de doadores falecidos, essa opção também vem sendo utilizada nos portadores de FHF com bons resultados 18 . O transplante de fígado auxiliar é técnica em que um órgão parcial é colocado de maneira heterotópica (sem retirar o fígado nativo, o órgão novo parcial é colocado em algum local na cavidade abdominal, por exemplo, na loja esplênica após a retirada do baço) ou ortotópica (uma parte do fígado nativo é retirado e o fígado parcial novo é colocado no lugar) enquanto o próprio fígado "regenera" 13 .…”

Section: Manejo Clínicounclassified

Falência hepática fulminante: etiologia, manejo e indicação para o transplante de fígado

Fonseca-Neto¹

2008

ABCD, arq. bras. cir. dig.

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INTRODUÇÃOFalência hepática fulminante (FHF) é síndrome complexa que reflete rápida progressão, risco de vida potencialmente reversível e deterioração da função hepática em pacientes sem doença prévia no fígado 23 . Desde o início de 1990 ocorreu mudança na epidemiologia da FHF. A origem viral vem diminuindo nos países ocidentais e a injúria induzida por drogas, acetaminofeno, vem assumindo a liderança. Nos últimos 20 anos, transplante de fígado de emergência emergiu como a única intervenção terapêutica que beneficia os pacientes com FHF avançada 22 . A apresentação clínica vai depender da severidade e da etiologia do dano hepático. Sintomas inespecíficos como náuseas, vômitos e desconforto abdominal poderão ser apresentação inicial dos pacientes com FHF 20 . A evolução desses sintomas ou o aparecimento desde o início de confusão mental, sangramento no trato digestório e hipoglicemia tornarão o diagnóstico mais óbvio 6 . Os resultados dos testes de função hepática e coagulação indicarão a severidade da agressão no fígado 5 . Praticamente, todos os sistemas são acometidos direta ou indiretamente pela disfunção grave hepática 4 . Ela pode apresentar encefalopatia, coagulopatia, alteração cardiovascular e nefrometabólica. ETIOLOGIAA encefalopatia 15 pode variar desde a apresentação subclínica e dificuldades na concentração (estágio I) ao coma profundo (estágio IV). O seu aparecimento e evolução para os estágios mais graves (grau IV) estão inversamente relacionados com o prognóstico, ou seja, maior estágio da encefalopatia pior prognóstico. Edema cerebral é distúrbio neurológico comum na FHF, sendo reportado na vasta maioria dos casos que progridem para o estágio IV da encefalopatia e é a principal causa de morte nos pacientes com FHF.O fígado exerce papel fundamental na síntese da

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Role of Liver Transplantation in Acute Liver Failure

Cited by 62 publications

References 156 publications

Chronic myeloid leukemia patient manifesting fatal hepatitis B virus reactivation during treatment with imatinib rescued by liver transplantation: case report and literature review

Chronic myeloid leukemia patient manifesting fatal hepatitis B virus reactivation during treatment with imatinib rescued by liver transplantation: case report and literature review

SIRS Score Reflects Clinical Features of Non-Acetaminophen-Related Acute Liver Failure with Hepatic Coma

Falência hepática fulminante: etiologia, manejo e indicação para o transplante de fígado

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