Etiology and outcome for 295 patients with acute liver failure in the United States

F. V. Schiodt, E. Atillasoy, A. O. Shakil, E. R. Schiff, C. Caldwell, K. V. Kowdley, R. Stribling, J. S. Crippin, S. Flamm, K. A. Somberg, H. Rosen, T. M. McCashland, J. E. Hay, W. M. Lee, H. Bodenheimer, J. Rakela, K. G. Benner, P. Martin, S. H B Han, A. T. Blei & 10 others K. A. Somberg, S. D. Lidofsky, S. Rouillard, T. Davern, R. H. Wiesner, M. K. Porayko, M. G. Peters, R. L. Carithers, A. G. Tzakis, M. J. Rodriguez

Research output: Contribution to journalArticle

314 Citations (Scopus)

Abstract

Little information is available on acute liver failure (ALF) in the United States. We gathered demographic data retrospectively for a 2-year period from July 1994 to June 1996 on all cases of ALF from 13 hospitals (12 liver transplant centers). Data on the patients included age, hepatic coma grade on admission, presumed cause, transplantation, and outcome. Among 295 patients, 74 (25%) survived spontaneously, 121 (41%) underwent transplantation, and 99 (34%) died without undergoing transplantation. Ninety-two of 121 patients (76%) survived 1 year after transplantation. Acetaminophen overdose was the most frequent cause (60 patients; 20%), followed by cryptogenic/non A non B non C (NANBNC; 15%), idiosyncratic drug reactions (12%), hepatitis B (10%), and hepatitis A (7%). Spontaneous survival rates were highest for patients with acetaminophen overdose (57%) and hepatitis A (40%) and lowest for those with Wilson's disease (no survivors of 18 patients). The transplantation rate was highest for Wilson's disease (17 of 18 patients; 94%) and lowest for autoimmune hepatitis (29%) and acetaminophen overdose (12%). Age did not differ between survivors and nonsurvivors, perhaps reflecting a selection bias for patients transferred to liver transplant centers. Coma grade on admission was not a significant determinant of outcome, but showed a trend toward affecting both survival and transplantation rate. These findings on retrospectively studied patients from the United States differ from those previously gathered in the United Kingdom and France, highlighting the need for further study of trends in each country.

Original languageEnglish (US)
Pages (from-to)29-34
Number of pages6
JournalLiver Transplantation and Surgery
Volume5
Issue number1
StatePublished - 1999

Fingerprint

Acute Liver Failure
Transplantation
Acetaminophen
Hepatolenticular Degeneration
Hepatitis A
Survivors
Survival Rate
Transplants
Autoimmune Hepatitis
Hepatic Encephalopathy
Selection Bias
Liver
Coma
Hepatitis B
France
Demography

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Schiodt, F. V., Atillasoy, E., Shakil, A. O., Schiff, E. R., Caldwell, C., Kowdley, K. V., ... Rodriguez, M. J. (1999). Etiology and outcome for 295 patients with acute liver failure in the United States. Liver Transplantation and Surgery, 5(1), 29-34.

Etiology and outcome for 295 patients with acute liver failure in the United States. / Schiodt, F. V.; Atillasoy, E.; Shakil, A. O.; Schiff, E. R.; Caldwell, C.; Kowdley, K. V.; Stribling, R.; Crippin, J. S.; Flamm, S.; Somberg, K. A.; Rosen, H.; McCashland, T. M.; Hay, J. E.; Lee, W. M.; Bodenheimer, H.; Rakela, J.; Benner, K. G.; Martin, P.; Han, S. H B; Blei, A. T.; Somberg, K. A.; Lidofsky, S. D.; Rouillard, S.; Davern, T.; Wiesner, R. H.; Porayko, M. K.; Peters, M. G.; Carithers, R. L.; Tzakis, A. G.; Rodriguez, M. J.

In: Liver Transplantation and Surgery, Vol. 5, No. 1, 1999, p. 29-34.

Research output: Contribution to journalArticle

Schiodt, FV, Atillasoy, E, Shakil, AO, Schiff, ER, Caldwell, C, Kowdley, KV, Stribling, R, Crippin, JS, Flamm, S, Somberg, KA, Rosen, H, McCashland, TM, Hay, JE, Lee, WM, Bodenheimer, H, Rakela, J, Benner, KG, Martin, P, Han, SHB, Blei, AT, Somberg, KA, Lidofsky, SD, Rouillard, S, Davern, T, Wiesner, RH, Porayko, MK, Peters, MG, Carithers, RL, Tzakis, AG & Rodriguez, MJ 1999, 'Etiology and outcome for 295 patients with acute liver failure in the United States', Liver Transplantation and Surgery, vol. 5, no. 1, pp. 29-34.
Schiodt FV, Atillasoy E, Shakil AO, Schiff ER, Caldwell C, Kowdley KV et al. Etiology and outcome for 295 patients with acute liver failure in the United States. Liver Transplantation and Surgery. 1999;5(1):29-34.
Schiodt, F. V. ; Atillasoy, E. ; Shakil, A. O. ; Schiff, E. R. ; Caldwell, C. ; Kowdley, K. V. ; Stribling, R. ; Crippin, J. S. ; Flamm, S. ; Somberg, K. A. ; Rosen, H. ; McCashland, T. M. ; Hay, J. E. ; Lee, W. M. ; Bodenheimer, H. ; Rakela, J. ; Benner, K. G. ; Martin, P. ; Han, S. H B ; Blei, A. T. ; Somberg, K. A. ; Lidofsky, S. D. ; Rouillard, S. ; Davern, T. ; Wiesner, R. H. ; Porayko, M. K. ; Peters, M. G. ; Carithers, R. L. ; Tzakis, A. G. ; Rodriguez, M. J. / Etiology and outcome for 295 patients with acute liver failure in the United States. In: Liver Transplantation and Surgery. 1999 ; Vol. 5, No. 1. pp. 29-34.
@article{7baa2328d3114d0c9ca9190267c92f48,
title = "Etiology and outcome for 295 patients with acute liver failure in the United States",
abstract = "Little information is available on acute liver failure (ALF) in the United States. We gathered demographic data retrospectively for a 2-year period from July 1994 to June 1996 on all cases of ALF from 13 hospitals (12 liver transplant centers). Data on the patients included age, hepatic coma grade on admission, presumed cause, transplantation, and outcome. Among 295 patients, 74 (25{\%}) survived spontaneously, 121 (41{\%}) underwent transplantation, and 99 (34{\%}) died without undergoing transplantation. Ninety-two of 121 patients (76{\%}) survived 1 year after transplantation. Acetaminophen overdose was the most frequent cause (60 patients; 20{\%}), followed by cryptogenic/non A non B non C (NANBNC; 15{\%}), idiosyncratic drug reactions (12{\%}), hepatitis B (10{\%}), and hepatitis A (7{\%}). Spontaneous survival rates were highest for patients with acetaminophen overdose (57{\%}) and hepatitis A (40{\%}) and lowest for those with Wilson's disease (no survivors of 18 patients). The transplantation rate was highest for Wilson's disease (17 of 18 patients; 94{\%}) and lowest for autoimmune hepatitis (29{\%}) and acetaminophen overdose (12{\%}). Age did not differ between survivors and nonsurvivors, perhaps reflecting a selection bias for patients transferred to liver transplant centers. Coma grade on admission was not a significant determinant of outcome, but showed a trend toward affecting both survival and transplantation rate. These findings on retrospectively studied patients from the United States differ from those previously gathered in the United Kingdom and France, highlighting the need for further study of trends in each country.",
author = "Schiodt, {F. V.} and E. Atillasoy and Shakil, {A. O.} and Schiff, {E. R.} and C. Caldwell and Kowdley, {K. V.} and R. Stribling and Crippin, {J. S.} and S. Flamm and Somberg, {K. A.} and H. Rosen and McCashland, {T. M.} and Hay, {J. E.} and Lee, {W. M.} and H. Bodenheimer and J. Rakela and Benner, {K. G.} and P. Martin and Han, {S. H B} and Blei, {A. T.} and Somberg, {K. A.} and Lidofsky, {S. D.} and S. Rouillard and T. Davern and Wiesner, {R. H.} and Porayko, {M. K.} and Peters, {M. G.} and Carithers, {R. L.} and Tzakis, {A. G.} and Rodriguez, {M. J.}",
year = "1999",
language = "English (US)",
volume = "5",
pages = "29--34",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "1",

}

TY - JOUR

T1 - Etiology and outcome for 295 patients with acute liver failure in the United States

AU - Schiodt, F. V.

AU - Atillasoy, E.

AU - Shakil, A. O.

AU - Schiff, E. R.

AU - Caldwell, C.

AU - Kowdley, K. V.

AU - Stribling, R.

AU - Crippin, J. S.

AU - Flamm, S.

AU - Somberg, K. A.

AU - Rosen, H.

AU - McCashland, T. M.

AU - Hay, J. E.

AU - Lee, W. M.

AU - Bodenheimer, H.

AU - Rakela, J.

AU - Benner, K. G.

AU - Martin, P.

AU - Han, S. H B

AU - Blei, A. T.

AU - Somberg, K. A.

AU - Lidofsky, S. D.

AU - Rouillard, S.

AU - Davern, T.

AU - Wiesner, R. H.

AU - Porayko, M. K.

AU - Peters, M. G.

AU - Carithers, R. L.

AU - Tzakis, A. G.

AU - Rodriguez, M. J.

PY - 1999

Y1 - 1999

N2 - Little information is available on acute liver failure (ALF) in the United States. We gathered demographic data retrospectively for a 2-year period from July 1994 to June 1996 on all cases of ALF from 13 hospitals (12 liver transplant centers). Data on the patients included age, hepatic coma grade on admission, presumed cause, transplantation, and outcome. Among 295 patients, 74 (25%) survived spontaneously, 121 (41%) underwent transplantation, and 99 (34%) died without undergoing transplantation. Ninety-two of 121 patients (76%) survived 1 year after transplantation. Acetaminophen overdose was the most frequent cause (60 patients; 20%), followed by cryptogenic/non A non B non C (NANBNC; 15%), idiosyncratic drug reactions (12%), hepatitis B (10%), and hepatitis A (7%). Spontaneous survival rates were highest for patients with acetaminophen overdose (57%) and hepatitis A (40%) and lowest for those with Wilson's disease (no survivors of 18 patients). The transplantation rate was highest for Wilson's disease (17 of 18 patients; 94%) and lowest for autoimmune hepatitis (29%) and acetaminophen overdose (12%). Age did not differ between survivors and nonsurvivors, perhaps reflecting a selection bias for patients transferred to liver transplant centers. Coma grade on admission was not a significant determinant of outcome, but showed a trend toward affecting both survival and transplantation rate. These findings on retrospectively studied patients from the United States differ from those previously gathered in the United Kingdom and France, highlighting the need for further study of trends in each country.

AB - Little information is available on acute liver failure (ALF) in the United States. We gathered demographic data retrospectively for a 2-year period from July 1994 to June 1996 on all cases of ALF from 13 hospitals (12 liver transplant centers). Data on the patients included age, hepatic coma grade on admission, presumed cause, transplantation, and outcome. Among 295 patients, 74 (25%) survived spontaneously, 121 (41%) underwent transplantation, and 99 (34%) died without undergoing transplantation. Ninety-two of 121 patients (76%) survived 1 year after transplantation. Acetaminophen overdose was the most frequent cause (60 patients; 20%), followed by cryptogenic/non A non B non C (NANBNC; 15%), idiosyncratic drug reactions (12%), hepatitis B (10%), and hepatitis A (7%). Spontaneous survival rates were highest for patients with acetaminophen overdose (57%) and hepatitis A (40%) and lowest for those with Wilson's disease (no survivors of 18 patients). The transplantation rate was highest for Wilson's disease (17 of 18 patients; 94%) and lowest for autoimmune hepatitis (29%) and acetaminophen overdose (12%). Age did not differ between survivors and nonsurvivors, perhaps reflecting a selection bias for patients transferred to liver transplant centers. Coma grade on admission was not a significant determinant of outcome, but showed a trend toward affecting both survival and transplantation rate. These findings on retrospectively studied patients from the United States differ from those previously gathered in the United Kingdom and France, highlighting the need for further study of trends in each country.

UR - http://www.scopus.com/inward/record.url?scp=0032903828&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032903828&partnerID=8YFLogxK

M3 - Article

VL - 5

SP - 29

EP - 34

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 1

ER -