Acute liver failure in children: A regional experience

Ee, L. C., Shepherd, R. W., Cleghorn, G. J., Lewindon, P. J., Fawcett, J., Strong, R. W. and Lynch, S. V. (2003) Acute liver failure in children: A regional experience. Journal of Paediatrics and Child Health, 39 2: 107-110. doi:10.1046/j.1440-1754.2003.00087.x


Author Ee, L. C.
Shepherd, R. W.
Cleghorn, G. J.
Lewindon, P. J.
Fawcett, J.
Strong, R. W.
Lynch, S. V.
Title Acute liver failure in children: A regional experience
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
ISSN 1034-4810
Publication date 2003
Sub-type Article (original research)
DOI 10.1046/j.1440-1754.2003.00087.x
Volume 39
Issue 2
Start page 107
End page 110
Total pages 4
Editor Frank Oberklaid
Place of publication Melbourne
Publisher Blackwell Science
Collection year 2003
Language eng
Subject C1
730204 Child health
321006 Gastroenterology and Hepatology
11 Medical and Health Sciences
1114 Paediatrics and Reproductive Medicine
Abstract Objective: To review the outcome of acute liver failure (ALF) and the effect of liver transplantation in children in Australia. Methodology: A retrospective review was conducted of all paediatric patients referred with acute liver failure between 1985 and 2000 to the Queensland Liver Transplant Service, a paediatric liver transplant centre based at the Royal Children's Hospital, Brisbane, that is one of three paediatric transplant centres in Australia. Results: Twenty-six patients were referred with ALF. Four patients did not require transplantation and recovered with medical therapy while two were excluded because of irreversible neurological changes and died. Of the 20 patients considered for transplant, three refused for social and/or religious reasons, with 17 patients listed for transplantation. One patient recovered spontaneously and one died before receiving a transplant. There were 15 transplants of which 40% (6/15) were < 2 years old. Sixty-seven per cent (10/15) survived > 1 month after transplantation. Forty per cent (6/15) survived more than 6 months after transplant. There were only four long-term survivors after transplant for ALF (27%). Overall, 27% (6/22) of patients referred with ALF survived. Of the 16 patients that died, 44% (7/16) were from neurological causes. Most of these were from cerebral oedema but two patients transplanted for valproate hepatotoxicity died from neurological disease despite good graft function. Conclusions: Irreversible neurological disease remains a major cause of death in children with ALF. We recommend better patient selection and early referral and transfer to a transplant centre before onset of irreversible neurological disease to optimize outcome of children transplanted for ALF.
Keyword Pediatrics
Liver Failure
Liver Transplant
Outcome
Paediatric
Fulminant Hepatic-failure
Transplantation
Criteria
Risk
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2004 Higher Education Research Data Collection
School of Medicine Publications
 
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