Transplant-free Survival in Chronic Liver Disease Presenting as Acute Liver Failure in Childhood

Transplantation
A Di GiorgioL D'Antiga

Abstract

In adults, the absence of a preexisting chronic liver disease (CLD) is required to diagnose acute liver failure (ALF). The pediatric classification does not consider this aspect, thus previous studies pooled together children with ALF and children with unknown CLD presenting with acute hepatic decompensation (ALF-CLD). We aimed to compare prevalence, features, and outcome of children with ALF-CLD to those with a proper ALF. Patients admitted between 1996 and 2017 because of ALF defined by Pediatric Acute Liver Failure criteria (raised transaminases, International Normal Ratio ≥2.0, no history of liver disease) were classified as ALF-CLD if diagnosed with autoimmune hepatitis, Wilson disease, Budd-Chiari syndrome, hepatitis B virus reactivation, inborn errors of metabolism. The others were classified as ALF. Seventy-four children (median age, 4 years; 1.0-8.8; male/female, 36/38] with ALF were found; 18 of <1 year of age were excluded. Fifty-six (median age, 6.6 years; 2.7-11.7; male/female, 23/33], 22 with ALF-CLD (autoimmune hepatitis, n = 14; Wilson disease, n = 6; inborn errors of metabolism, n = 2) and 34 with ALF (paracetamol overdose, n = 6; viral infections, n = 3; mushroom poisoning, n = 5; indeterminate, n = 20) were c...Continue Reading

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Citations

Oct 14, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Manuel MendizabalFernando Rubinstein
Nov 30, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Angelo Di Giorgio, Lorenzo D'Antiga
Nov 21, 2020·Pediatric Gastroenterology, Hepatology & Nutrition·Giuliana BerardiStephen Aronoff
Mar 6, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Ali IslekGurkan Ozturk
Mar 30, 2021·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·A Di GiorgioL D'Antiga
Jun 8, 2021·Transplantation Reviews·Joana QuadrosMaria Francelina Lopes

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