The management of acute hepatic failure

Sherlock, Sheila; Parbhoo, S. P.

doi:10.1136/pgmj.47.549.493

Cited by 17 publications

(4 citation statements)

References 27 publications

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“…Acute liver failure (ALF) is a life-threatening condition characterized by rapidly deteriorating liver function [1]. At a joint review from the American Association for the Study of Liver Diseases during Digestive Diseases Week in 2001, the incidence of ALF in the United States was estimated to be more than 2000 cases each year [2].…”

mentioning

confidence: 99%

“…In the pre–liver transplantation era, the survival probability for ALF ranged from only 6% to 20% [1,3-5]. Although transplant-free survival of patients with ALF depends on the etiology of liver injury (eg, higher transplant-free survival in acetaminophen-induced ALF compared to hepatitis B–induced ALF), liver transplantation significantly improved outcomes in ALF [6].…”

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confidence: 99%

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Outcomes of Living Versus Deceased Donor Liver Transplantation for Acute Liver Failure in the United States

Urrunaga¹,

Rachakonda²,

Magder³

et al. 2014

Transplantation Proceedings

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Clinical outcomes for living donor liver transplantation (LDLT) for acute liver failure (ALF) in the United States remain to be determined. To address this gap in knowledge, we examined post–liver transplantation outcomes of adults with ALF undergoing LDLT and deceased donor liver transplantation (DDLT) in the United States. We analyzed Organ and Procurement and Transplantation Network data for adults with ALF who were listed for liver transplantation as status 1 or 1A and who underwent LDLT (N = 21) or DDLT (N = 2316) between October 1987 and April 2011. We found no strong evidence that the survival probabilities for adults with ALF who underwent LDLT were inferior to those who underwent DDLT (P = .764). In adults with ALF who underwent LDLT, 1- and 5-year survival probabilities were both 71%; for DDLT these probabilities were 79% and 71%, respectively. In adults with ALF, 1- and 5-year liver graft survival probabilities, respectively, were 62% and 57% for LDLT, and 74% and 66% for DDLT. In these series of adults with ALF who were listed as status 1 or 1A, patient and graft survival rates for LDLT were similar to those for DDLT. Our findings suggest that if deceased donor livers are unavailable, LDLT is an acceptable option in experienced centers for adults with ALF.

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confidence: 99%

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confidence: 99%

Outcomes of Living Versus Deceased Donor Liver Transplantation for Acute Liver Failure in the United States

Urrunaga¹,

Rachakonda²,

Magder³

et al. 2014

Transplantation Proceedings

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“…In the presence of liver disease, multiple abnor malities of coagulation factors render evaluation and interpretation of acute changes in hemostasis quite difficult. In fulminant hepatic failure, hemor rhage may be evident in from 41 to 73% of cases, [485][486][487][488][489] with mortality from 10 to 65%. [489][490][491] DIC may occur and is associated with fulminant hepatic failure of various causes.…”

Section: Liver Diseasementioning

confidence: 99%

Clinical Aspects of Disseminated Intravascular Coagulation: A Clinician's Point of View

Baker¹

1989

Semin Thromb Hemost

151

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DIC is a disorder of coagulation that is demonstrated to occur in many settings. In view of the fulminant nature of the disorder once it is fully activated, the potential for considerable morbidity and mortality, and the difficulty in treating this syndrome, the necessity for a thorough understanding of the disorder is clear. A high index of suspicion is absolutely essential; however, this requires a thorough knowledge of the medical and surgical disorders in which DIC is likely to occur. The presenting manifestations of DIC, the time course of development of the fulminant syndrome, and the specific complications of the disorder may be intrinsically related to the specific clinical characteristics of the underlying disease. Clinical evaluation of the patient must be comprehensive and consider not only the laboratory and clinical manifestations of DIC but the triggering illness. Without the ability to treat the underlying primary illness, controlling or abating the DIC may be difficult or impossible. This comprehensive review of the disease entities in which DIC is likely to occur and the associated clinical manifestations will, it is hoped, guide a more precise definition of the overall clinical picture that confronts the clinician when evaluating a patient with possible DIC.

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“…In general, however, these data are lacking . What is known is that the mortality in adults with AFHF who develop stage 3 or 4 encephalopathy approaches 90% in several series (27)(28)(29). Although previous reports regarding the role of transplantation for treatment of AFHF were less encouraging (26), the authors' recent experience suggests that better survival rates may be obtained by aggressive management of cerebral edema while awaiting referral of a donor organ.…”

Section: Acute Fulminant Hepatic Failurementioning

confidence: 99%

Liver Transplantation Therapy for Children

Shaw,

Wood,

Kaufman

et al. 1988

J. pediatr. gastroenterol. nutr.

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The management of acute hepatic failure

Cited by 17 publications

References 27 publications

Outcomes of Living Versus Deceased Donor Liver Transplantation for Acute Liver Failure in the United States

Outcomes of Living Versus Deceased Donor Liver Transplantation for Acute Liver Failure in the United States

Clinical Aspects of Disseminated Intravascular Coagulation: A Clinician's Point of View

Liver Transplantation Therapy for Children

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