scholarly journals Creatinine-lactate score predicts mortality in non-acetaminophen-induced acute liver failure in patients listed for liver transplantation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Estela Regina Ramos Figueira ◽  
Joel Avancini Rocha-Filho ◽  
Cinthia Lanchotte ◽  
Lucas Souto Nacif ◽  
Luciana Bertocco de Paiva Haddad ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Prognostic Factors ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Multiple Logistic Regression Analysis ◽  
Prognostic Indicators ◽  
Time Interval ◽  
Drug Induced ◽  
King's College ◽  
King’S College Criteria

Abstract Background The aim of this study was to analyze prognostic indicators of in-hospital mortality among patients listed for urgent liver transplantation (LT) for non-acetaminophen (APAP)-induced acute liver failure (ALF). Methods ALF patients listed for LT according to the King’s College Criteria were retrospectively reviewed. Variables were recorded from medical records and electronic databases (HCMED and RedCap). Results The study included 100 patients, of which 69 were subject to LT and 31 died while waiting for LT. Patients were 35.5 ± 14.73 years old, and 78% were females. The main etiologies were virus (17%), drug-induced (32%), autoimmune (15%), and indeterminate hepatitis (31%). The prioritization-to-LT time interval was 1.5 days (0–9). The non-LT patients showed higher lactate (8.71 ± 5.36 vs. 4.48 ± 3.33 mmol/L), creatinine (229 ± 207 vs. 137 ± 136 µm/L), MELD (44 ± 8 vs. 38 ± 8), and BiLE scores (15.8 ± 5.5 vs. 10.3 ± 4.1) compared to LT patients (p < 0.05). Multiple logistic regression analysis identified creatinine and lactate as independent prognostic factors, and a creatinine-lactate (CL) score was developed. ROC analysis showed that creatinine, lactate, MELD, BiLE, and CL scores had considerable specificity (71–88%), but only BiLE, lactate, and CL presented high sensitivities (70%, 80%, and 87% respectively). AUCs were 0.696 for creatinine, 0.763 for lactate, 0.697 for MELD, 0.814 for BiLE, and 0.835 for CL. Conclusions CL and BiLE scores predict mortality with more accuracy than MELD in patients with ALF during prioritization time. Creatinine and lactate are independent prognostic factors for mortality.

scholarly journals Acute Liver Failure Caused byAmanita phalloidesPoisoning

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Santi ◽  
Caterina Maggioli ◽  
Marianna Mastroroberto ◽  
Manuel Tufoni ◽  
Lucia Napoli ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Rna Polymerase Ii ◽  
Gastrointestinal Symptoms ◽  
Amanita Phalloides ◽  
Prognostic Indicators ◽  
Mushroom Poisoning ◽  
Lag Phase ◽  
Kidney Involvement

Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion ofAmanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage fromAmanita phalloidesis related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate afterAmanita phalloidespoisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options.

scholarly journals Successful Management of Acute Liver Failure Patients Waiting for Liver Transplantation by On-Line Hemodiafiltration with an Arteriovenous Fistula

2016 ◽  
Vol 10 (1) ◽  
pp. 144-150 ◽  
Author(s):  
Yuki Haga ◽  
Shin Yasui ◽  
Tatsuo Kanda ◽  
Noriyuki Hattori ◽  
Toru Wakamatsu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Prognostic Factors ◽  
Infectious Diseases ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Treatment Options ◽  
Successful Management ◽  
On Line

On-line hemodiafiltration (OLHDF) is one of the treatment options in the management of acute liver failure (ALF) in Japan. It is essential to avoid infection in the management of ALF. In fact, infection is one of the prognostic factors in ALF. In this report, we present a middle-aged Japanese man with ALF associated with benzbromarone use. He was successfully managed without infection until liver transplantation by creating an arteriovenous fistula for OLHDF. Utilizing an arteriovenous fistula for OLHDF, rather than inserting a vascular access catheter, is a beneficial option to avoid infectious diseases in the management of ALF.

scholarly journals Drug-Induced Autoimmune Hepatitis From Hydralazine Leading to Acute Liver Failure and Liver Transplantation

2019 ◽  
Vol 6 (10) ◽  
pp. e00252 ◽  
Author(s):  
Jasleen Grewal ◽  
Angela Doan ◽  
Annie S. Hong ◽  
Arpit Amin ◽  
Jason V. Scapa ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Autoimmune Hepatitis ◽  
Drug Induced

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

2002 ◽  
Vol 16 (10) ◽  
pp. 672-676 ◽  
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.

Novel predictors for liver transplantation or death in drug-induced acute liver failure

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sabine Weber ◽  
Christine Woischke ◽  
Gerald Denk ◽  
Alexander L. Gerbes
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Drug Induced
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