Indeterminate etiology of acute liver failure in North America : Less common, still grave prognosis
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
BACKGROUND: The etiology of acute liver failure (ALF) remains one of the most important factors in determining prognosis and predicting outcomes. In a significant proportion of ALF cases, however, the etiology remains unknown and is categorized as indeterminate ALF (IND-ALF). In this study, we summarize findings from patients with IND-ALF from 32 transplant centers across the United States, and we compare laboratory, prognostic, and outcome data for patients with IND-ALF.
METHODS: Between 1998 and 2019, 3364 adult patients with ALF or acute liver injury (ALI) from 32 liver transplant centers were enrolled in the ALFSG registry. The primary clinical outcome of interest was 21-day transplant-free survival (TFS).
RESULTS: Of the 3364 patients enrolled in the ALFSG registry, 3.4 % (n = 114) were adjudicated as true indeterminate. On multivariate analysis, patients with a lower bilirubin, lower INR, lack of use of mechanical ventilation and no clinical features of coma at baseline had a higher odds ratio of transplant free survival. The number of deaths were similar between patients with true-IND ALF versus patients with indeterminable ALF (29.8% vs. 27.2%), with almost half of the patients requiring liver transplant (42.1% vs. 45.7%).
CONCLUSION: We illustrate the poor prognoses that true-IND-ALF and indeterminable ALF carry and the need for emergency liver transplantation in most cases.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
Clinical transplantation - 37(2023), 12 vom: 17. Dez., Seite e15128 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Patel, Parita V [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute liver failure |
|---|
| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 18.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/ctr.15128 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362026475 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362026475 | ||
| 003 | DE-627 | ||
| 005 | 20240418232302.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/ctr.15128 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1379.xml |
| 035 | |a (DE-627)NLM362026475 | ||
| 035 | |a (NLM)37705387 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Patel, Parita V |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Indeterminate etiology of acute liver failure in North America |b Less common, still grave prognosis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 18.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: The etiology of acute liver failure (ALF) remains one of the most important factors in determining prognosis and predicting outcomes. In a significant proportion of ALF cases, however, the etiology remains unknown and is categorized as indeterminate ALF (IND-ALF). In this study, we summarize findings from patients with IND-ALF from 32 transplant centers across the United States, and we compare laboratory, prognostic, and outcome data for patients with IND-ALF | ||
| 520 | |a METHODS: Between 1998 and 2019, 3364 adult patients with ALF or acute liver injury (ALI) from 32 liver transplant centers were enrolled in the ALFSG registry. The primary clinical outcome of interest was 21-day transplant-free survival (TFS) | ||
| 520 | |a RESULTS: Of the 3364 patients enrolled in the ALFSG registry, 3.4 % (n = 114) were adjudicated as true indeterminate. On multivariate analysis, patients with a lower bilirubin, lower INR, lack of use of mechanical ventilation and no clinical features of coma at baseline had a higher odds ratio of transplant free survival. The number of deaths were similar between patients with true-IND ALF versus patients with indeterminable ALF (29.8% vs. 27.2%), with almost half of the patients requiring liver transplant (42.1% vs. 45.7%) | ||
| 520 | |a CONCLUSION: We illustrate the poor prognoses that true-IND-ALF and indeterminable ALF carry and the need for emergency liver transplantation in most cases | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acute liver failure | |
| 650 | 4 | |a indeterminate acute liver failure | |
| 650 | 4 | |a transplant free survival | |
| 700 | 1 | |a Livingston, Sherry |e verfasserin |4 aut | |
| 700 | 1 | |a Rakela, Jorge L |e verfasserin |4 aut | |
| 700 | 1 | |a Stravitz, R Todd |e verfasserin |4 aut | |
| 700 | 1 | |a Reuben, Adrian |e verfasserin |4 aut | |
| 700 | 1 | |a Bass, Nathan M |e verfasserin |4 aut | |
| 700 | 1 | |a Tujios, Shannan R |e verfasserin |4 aut | |
| 700 | 1 | |a Larson, Anne M |e verfasserin |4 aut | |
| 700 | 1 | |a Sussman, Norman L |e verfasserin |4 aut | |
| 700 | 1 | |a Rule, Jody A |e verfasserin |4 aut | |
| 700 | 1 | |a Durkalski-Mauldin, Valerie L |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, William M |e verfasserin |4 aut | |
| 700 | 1 | |a Ganger, Daniel R |e verfasserin |4 aut | |
| 700 | 0 | |a Acute Liver Failure Study Group (ALFSG) |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical transplantation |d 1987 |g 37(2023), 12 vom: 17. Dez., Seite e15128 |w (DE-627)NLM07493306X |x 1399-0012 |7 nnns |
| 773 | 1 | 8 | |g volume:37 |g year:2023 |g number:12 |g day:17 |g month:12 |g pages:e15128 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/ctr.15128 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 37 |j 2023 |e 12 |b 17 |c 12 |h e15128 | ||