Acute Liver Failure in a Metropolitan Area in Germany: a Retrospective Study (2002 – 2008)

Abstract

In providing first data on current ALF etiologies Germany, this study reveals that drug toxicity - in particular due to acetaminophen - has replaced viral hepatitis as the most single frequent cause of ALF in a densely populated urban area; this correlates with similar findings in the USA, the UK and Scandinavia. Lower body mass indices and elevated cholestatic enzyme levels had statistically significant prognostic power.

Obesity Affects the Liver – The Link between Adipocytes and Hepatocytes

“…Multivariate analyses in patients without preexisting liver damage (for example NAFLD) did not identify BMI as an independent predictor [103] . Preexisting liver damage due to obesity renders subjects more susceptible to a 'second hit' (such as by drug toxicity or viral hepatitis), which results in acute-on-chronic liver failure [101,102,104] ; this is in line with findings from overweight rodents.…”

“…Preexisting liver damage due to obesity renders subjects more susceptible to a 'second hit' (such as by drug toxicity or viral hepatitis), which results in acute-on-chronic liver failure [101,102,104] ; this is in line with findings from overweight rodents. Therefore, obesity should be considered as a relevant prognostic factor in patients with ALF [103] .…”

Systematic review: acute liver failure – one disease, more than 40 definitions

“…75 27 HE within 2 months of the onset of hepatitis symptoms, and with a plasma PTA < 40%. 76 28 4 weeks of disease onset without pre-existing liver disease, INR 1.5, with and without HE grade1 77 29 HE > II, within 4 weeks of the onset of clinical symptoms, PTT and HPT < 40% at the time of coma. 78 30 HE less than 2 weeks after the onset of jaundice SubFHF -HE between 2 weeks and 3 months after the onset of jaundice 79 31 HE II and PTA 40%.…”

An Ex Vivo Perfusion System Emulating In Vivo Conditions in Noncirrhotic and Cirrhotic Human Liver

“…Likewise, chronic liver damage clinically leads to a continuous decline in cell numbers. This is paralleled by a decreasing release of liver enzymes (Canbay et al, 2009), which is sharply contrasted by the sudden and extensive organ damage in acute liver failure (Bechmann et al, 2010). Consequently, high ALT and AST values are associated with better outcome upon acute liver failure (Canbay et al, 2009).…”