Hadem, Johannes and Tacke, Frank and Bruns, Tony and Langgartner, Julia and Strnad, Pavel and Denk, Gerald U. and Fikatas, Panagiotis and Manns, Michael P. and Hofmann, Wolf P. and Gerken, Guido and Gruenhage, Frank and Umgelter, Andreas and Trautwein, Christian and Canbay, Ali (2012) Etiologies and Outcomes of Acute Liver Failure in Germany. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 10 (6). pp. 664-669. ISSN 1542-3565,
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND & AIMS: Acute liver failure (ALP) is a severe form of acute liver injury that can progress to multiple organ failure. We investigated causes and outcomes of ALF. METHODS: Eleven university medical centers in Germany were asked to report patients with (primary) severe acute liver injury (sALI) (international normalized ratio [INR] > 1.5 but no hepatic encephalopathy) and primary ALF (INR > 1.5 with overt hepatic encephalopathy) treated from 2008 to 2009. Data were analyzed from 46 patients with sALI and 109 patients with ALF. RESULTS: The most frequent etiologies of primary ALF were non-acetaminophen drug-induced (32%), indeterminate (24%), and viral (21%); acetaminophen ingestion was the cause of ALF in only 9% of patients. The support of a ventilator was required by 44% of patients with ALF, vasopressors by 38%, and renal replacement by 36%. Seventy-nine patients with ALF (72%) survived until hospital discharge, 38 (35%) survived without emergency liver transplantation (ELT), and 51 received ELT (47%); 80% of patients who received ELT survived until discharge from the hospital. CONCLUSIONS: In Germany, drug toxicity, indeterminate etiology, and viral hepatitis appear to be the major causes of primary ALF, which has high mortality. Patients with ALF are at great risk of progressing to multiple organ failure, but 80% of patients who receive ELT survive until discharge from the hospital.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FULMINANT HEPATIC-FAILURE; UNITED-STATES; MELD SCORE; TRANSPLANTATION; MULTICENTER; PROGNOSIS; CRITERIA; INJURY; Hepatic Failure; Acute Hepatitis; King's College Criteria; Liver Transplantation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 May 2020 05:59 |
| Last Modified: | 13 May 2020 05:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18673 |
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