Timing of liver transplantation for pediatric acute liver failure due to mushroom poisoning: a case report and literature review

Abstract

Background: Pediatric acute liver failure is a rare, life-threatening illness. Mushroom poisoning is a rare etiology. For patients with irreversible pediatric acute liver failure, liver transplantation is the ultimate lifesaving therapy. However, it is difficult to determine the optimal timing of transplantation. Here, we present a case of pediatric acute liver failure due to mushroom poisoning in northeastern China. He was treated with liver transplantation and recovered. To our knowledge, there are few reports about liver transplantation for pediatric acute liver failure caused by mushroom poisoning in mainland China. Case presentation: The patient was a previously healthy 9-year-old boy who gradually developed nausea, vomiting, jaundice and coma within 5 days after ingesting mushrooms. He was diagnosed with mushroom poisoning and acute liver failure. He was treated with conservative care but still deteriorated. On the 7th day after poisoning, he underwent LT due to grade IV hepatic encephalopathy. Twenty days later, he recovered and was discharged. A review of the literature revealed that the specific criteria and optimal timing of transplantation remain to be determined. Conclusions: Patients with pediatric acute liver failure should be transferred to a center with a transplant unit early. Once conservative treatment fails, liver transplantation should be performed.

Severe Hepatotoxicity in Mushroom Poisoning by Lepiota brunneoincarnata from Complete Recovery to Liver Transplantation: A Case Series with Review on Liver Function Tests and Liver Histopathology

“…Liver transplantation has dramatically improved the survival rate and remains the cornerstone of treatment in some patients with fulminant hepatic failure. Organ transplantation requires available organ donation, so it is not 7 International Journal of Hepatology always easy, and it is also a costly risky procedure [22][23][24].…”

Demographics and Clinical Characteristics Assessment of Severe Acute Toxic Ingestions in Pediatric Patients

“…The artificial liver system will be used in these cases. Once the artificial liver system treatment effect is poor, liver transplantation will be started 25 …”

“…Once the artificial liver system treatment effect is poor, liver transplantation will be started. 25 It is crucial for long-term follow-up of pediatric patients with poisons. In this way, we can know whether there is "rebound" damage after discharge.…”

Mantar Zehi̇rlenmesi̇: Tek Merkezden 10 Yillik Pedi̇atri̇k Aci̇l Başvurularinin Geri̇ye Dönük Değerlendi̇ri̇lmesi̇

“…Mantar zehirlenmelerine bağlı karaciğer yetmezliği gelişen hastaların prognozu kötüdür ve hayat kurtarıcı tedavi yöntemi karaciğer transplantasyonudur (22). Literatürde mantar zehirlenmesini takiben ölümün mantarların türüne ve toksisitesine bağlı olarak %1-12 arasında değişen sıklıkta olduğu bildirilmiştir, bizim değerlendirmemizi kapsayan 10 yıllık sürede mortal seyreden olgumuz yoktu (5,17).…”