Long‐term outcome in patients with acute liver failure

Putignano, Antonella; Figorilli, Francesco; Alabsawy, Eman; Agarwal, Banwari; Jalan, Rajiv

doi:10.1111/liv.13914

Cited by 15 publications

(8 citation statements)

References 25 publications

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“…LF is a clinical syndrome characterized by severe liver damage, coagulation disorders, jaundice, hepatic encephalopathy, and ascites (Liver, 2019). It has a high incidence, high mortality, and low cure rate (Putignano et al, 2018;Jalan et al, 2021). There are currently no specific pharmaceutical treatments for LF, with liver transplantation representing the only curative treatment option (Liver, 2019).…”

Section: Exosomes and Liver Failurementioning

confidence: 99%

Nucleic acids and proteins carried by exosomes from various sources: Potential role in liver diseases

Xie

Qian

2022

Front. Physiol.

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Exosomes are extracellular membrane-encapsulated vesicles that are released into the extracellular space or biological fluids by many cell types through exocytosis. As a newly identified form of intercellular signal communication, exosomes mediate various pathological and physiological processes by exchanging various active substances between cells. The incidence and mortality of liver diseases is increasing worldwide. Therefore, we reviewed recent studies evaluating the role of exosomes from various sources in the diagnosis and treatment of liver diseases.

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Section: Exosomes and Liver Failurementioning

confidence: 99%

Nucleic acids and proteins carried by exosomes from various sources: Potential role in liver diseases

Xie

Qian

2022

Front. Physiol.

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“…However, in ALF patients, its use is limited by the risk of significant intracranial hemorrhage and limited evidence proving its clinical benefit 5,6 . The rise in spontaneous and post liver transplant (LT) survival rate of patients with ALF observed during the last decade further questions the benefit of invasive ICH monitoring in this context 1,2,7–10 …”

Section: Introductionmentioning

confidence: 99%

“…5,6 The rise in spontaneous and post liver transplant (LT) survival rate of patients with ALF observed during the last decade further questions the benefit of invasive ICH monitoring in this context. 1,2,[7][8][9][10] Transcranial doppler (TCD) is widely used in neurocritical care and traumatology for cerebral blood flow evaluation and ICH detection 11,12 using diastolic velocity and pulsatility index (PI) defined by PI = (Vs −−Vd) Vm (systolic, diastolic, and mean velocities, respectively).…”

mentioning

confidence: 99%

Evaluation of transcranial Doppler use in patients with acute liver failure listed for emergency liver transplantation

Picard

Sigaut

Roux

et al. 2023

Clinical Transplantation

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Purpose Acute liver failure (ALF) is characterized by hepatic encephalopathy (HE) often due to intracranial hypertension (ICH). The risk/benefit‐balance of intraparenchymal pressure catheter monitoring is controversial during ALF. Aims Perform an evaluation of transcranial Doppler (TCD) use in patients with ALF listed for emergency liver transplantation. Material and methods Single center retrospective cohort study including all patients registered on high emergency LT list between 2012 and 2018. All TCD measurements performed during ICU stay after listing and after LT (when performed) were recorded. TCD was considered abnormal when pulsatility index (PI) was >1.2. Results Among 106 patients with ALF, forty‐seven (44%) had a TCD while on list. They had more severe liver and extrahepatic organ failure. When performed, TCD was abnormal in 51% of patients. These patients more frequently developed ICH events (45% vs. 13%, p = .02) and more frequently required increase in sedative drugs and vasopressors. While 22% of patients with normal TCD spontaneously survived, all of those with abnormal TCD died or were transplanted (p = .02). All transplanted patients who had abnormal exams normalized their TCD within 2 (1–2) days after LT. Conclusion TCD may be a useful non‐invasive tool for ICH detection and management, then guide sedation withdrawal.

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“…[3] Spontaneous survivors of ALF who are treated conservatively have a good prognosis compared with ALF patients who undergo liver transplantation. [4] Improvement in the therapeutic strategy for ALF is therefore needed.…”

Section: Introductionmentioning

confidence: 99%

Changes in platelet levels and prognosis in patients with acute liver failure and late-onset hepatic failure

et al. 2022

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The therapeutic strategies for acute liver failure (ALF) and late-onset hepatic failure (LOHF) still have room for improvement. Recent studies have reported an association between platelets and the pathophysiology of ALF. In this study, we investigated changes in platelet levels and clinical findings in ALF and LOHF patients. We retrospectively investigated the clinical data of 62 patients with ALF and LOHF. We analyzed the association between changes in platelet levels for 7 days after admission and the prognosis in patients with ALF and LOHF. The factors associated with changes in platelet levels were also analyzed. The platelet levels on days 1, 3, and 7 were significantly lower in the patients who died or underwent liver transplantation than in the spontaneous survivors. Administration of recombinant thrombomodulin was associated with spontaneous survival. The platelet levels in patients who met the King’s College Hospital Criteria or the Japanese scoring system (JSS) for ALF ≥ 4 were significantly decreased 7 days after admission. The area under the receiver operating characteristic curve (AUROC) of a JSS score of 3 for predicting low platelet levels on day 7 was 0.903. Decreased platelet levels were associated with poor prognosis in patients with ALF and LOHF. The patients with low platelet levels and JSS scores on admission showed a high AUROC for predicting low platelet levels on day 7. Decreased platelet levels after admission may be a simple prognostic marker in ALF and LOHF patients.

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Long‐term outcome in patients with acute liver failure

Cited by 15 publications

References 25 publications

Nucleic acids and proteins carried by exosomes from various sources: Potential role in liver diseases

Nucleic acids and proteins carried by exosomes from various sources: Potential role in liver diseases

Evaluation of transcranial Doppler use in patients with acute liver failure listed for emergency liver transplantation

Changes in platelet levels and prognosis in patients with acute liver failure and late-onset hepatic failure

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