P309 PROGNOSTIC MODEL FOR PREDICTING DRUG-INDUCED ACUTE LIVER FAILURE

Acute liver failure produces widespread physiologic derangements including encephalopathy, coagulopathy, peripheral vasodilation, a systemic inflammatory response, and multiorgan failure. Morbidity is significant, and mortality is 50%. The classification of liver failure and the various etiologies, including viral hepatitis, drug-induced, toxins, and autoimmunity are reviewed here. The multisystem effects of acute liver failure influence all aspects of perioperative care and adequate supportive care during this time is crucial to providing the best possible outcome for the patient. Specific treatment objectives and recommendations are discussed, and the anesthetic management with regard to drug choices, hemodynamic goals, and intraoperative monitoring is reviewed.

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Acute Liver Failure

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0038-1673372 ◽

2018 ◽

Vol 39 (05) ◽

pp. 513-522 ◽

Cited By ~ 6

Author(s):

Priyanka Rajaram ◽

Ram Subramanian

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Multiorgan Failure ◽

Drug Induced ◽

Detailed Review ◽

Drug Induced Liver Injury ◽

The Common ◽

Organ Dysfunctions ◽

Common Laboratory

AbstractAcute liver failure (ALF) is a condition that can rapidly progress to multiorgan failure. This article focuses on the diagnosis and management of ALF. We provide a detailed review of the common etiologies of ALF, including acetaminophen overdose, viral hepatitis, drug-induced liver injury, Wilson's disease, and autoimmune hepatitis. The article then addresses how to recognize ALF and reviews the role of common laboratory and imaging tests in establishing this diagnosis. The remainder of the article details the management of hepatic and extrahepatic organ dysfunctions in ALF. The article concludes with a discussion regarding the prognostication of patients with ALF and the criteria for considering liver transplantation.

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A novel, bedside, etiology specific prognostic model (Peds-HAV) in hepatitis A induced pediatric acute liver failure

Hepatology International ◽

10.1007/s12072-020-10050-0 ◽

2020 ◽

Vol 14 (4) ◽

pp. 483-490

Author(s):

Bikrant Bihari Lal ◽

Vikrant Sood ◽

Pandey Snehavardhan ◽

Rajeev Khanna ◽

Samba Siva Rao Pasupuleti ◽

...

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Prognostic Model ◽

Hepatitis A ◽

Pediatric Acute Liver Failure

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Association Between Plasma Level of Galectin-9 and Survival of Patients With Drug-Induced Acute Liver Failure

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2015.09.040 ◽

2016 ◽

Vol 14 (4) ◽

pp. 606-612.e3 ◽

Cited By ~ 8

Author(s):

Hugo R. Rosen ◽

Scott W. Biggins ◽

Toshiro Niki ◽

Jane Gralla ◽

Holly Hillman ◽

...

Keyword(s):

Plasma Level ◽

Liver Failure ◽

Acute Liver Failure ◽

Drug Induced

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Is Sensitivity the Key Measure to Predict Acute Liver Failure in Drug-Induced Liver Injury Patients?

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2015.10.002 ◽

2016 ◽

Vol 14 (6) ◽

pp. 918

Author(s):

M. Robles-Diaz ◽

R.J. Andrade ◽

N. Kaplowitz

Keyword(s):

Liver Injury ◽

Liver Failure ◽

Acute Liver Failure ◽

Drug Induced ◽

Drug Induced Liver Injury

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Etiology and Outcome of Acute Liver Failure: Experience from a Liver Transplantation Centre in Montreal

Canadian Journal of Gastroenterology ◽

10.1155/2002/328415 ◽

2002 ◽

Vol 16 (10) ◽

pp. 672-676 ◽

Cited By ~ 20

Author(s):

Geneviève Tessier ◽

Edith Villeneuve ◽

Jean-Pierre Villeneuve

Keyword(s):

Liver Transplantation ◽

Liver Injury ◽

Liver Failure ◽

Acute Liver Failure ◽

Rapid Development ◽

Significant Proportion ◽

Rare Condition ◽

Unknown Origin ◽

The United States ◽

Drug Induced

BACKGROUND: Acute liver failure is a rare condition in which massive liver injury is associated with the rapid development of hepatic encephalopathy. Although viral hepatitis and drug-induced liver injury are the most common causes, no specific etiology is found in a substantial proportion of cases reported from Europe and the United States.AIM: To determine the etiology and outcome of patients with acute liver failure in the authors’ institution.PATIENTS AND METHODS: The charts of 81 consecutive patients admitted to Saint-Luc between 1991 and 1999 were reviewed.RESULTS: The etiology was viral in 27 cases (33.2%), toxic or drug-induced in 22 (27.2%), of unknown origin in 22 (27.2%) and due to various causes in 10 (12.3%) (autoimmune, vascular, cancer). Of the 81 patients, 16% survived without liver transplantation, and 84% died or underwent liver transplantation. Survival without liver transplantation differed according to the mode of presentation: the survival rate was 27% in patients with hyperacute liver failure, 7% in those with acute liver failure and 0% in those with subacute liver failure. Among the 38 patients who underwent liver transplantation, survival one year after transplantation was 71%. In the 30 patients who died without liver transplantation, the main causes of death were cerebral edema and sepsis.CONCLUSIONS: Acute liver failure is associated with a high mortality, and liver transplantation is the treatment of choice. In a significant proportion of cases, the etiology remains undetermined and is probably related to yet unidentified hepatotropic viruses.

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