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; 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

doi:10.1002/lt.500050102

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. BleiK. 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

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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 language	English (US)
Pages (from-to)	29-34
Number of pages	6
Journal	Liver Transplantation and Surgery
Volume	5
Issue number	1
DOIs	https://doi.org/10.1002/lt.500050102
State	Published - 1999

ASJC Scopus subject areas

Surgery
Hepatology

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10.1002/lt.500050102

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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., ... 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. https://doi.org/10.1002/lt.500050102

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. https://doi.org/10.1002/lt.500050102

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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.}",

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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.

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

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