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Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand.
| Content Provider | Europe PMC |
|---|---|
| Author | Getsuwan, Songpon Lertudomphonwanit, Chatmanee Tanpowpong, Pornthep Thirapattaraphan, Chollasak Tim-Aroon, Thipwimol Wattanasirichaigoon, Duangrurdee Treepongkaruna, Suporn |
| Copyright Year | 2020 |
| Abstract | PurposePediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF.MethodsWe retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT.ResultsWe included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy (p<0.01), hypotension (p=0.02), gastrointestinal bleeding (p=0.03), increased intracranial pressure (p=0.04), and higher peak serum lactate level (p=0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT.ConclusionViral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7667225&blobtype=pdf |
| ISSN | 22348646 |
| Journal | Pediatric Gastroenterology, Hepatology & Nutrition [Pediatr Gastroenterol Hepatol Nutr] |
| Volume Number | 23 |
| DOI | 10.5223/pghn.2020.23.6.539 |
| PubMed Central reference number | PMC7667225 |
| Issue Number | 6 |
| PubMed reference number | 33215025 |
| e-ISSN | 22348840 |
| Language | English |
| Publisher | The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition |
| Publisher Date | 2020-11-05 |
| Access Restriction | Open |
| Rights License | This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2020 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition |
| Subject Keyword | Acute liver failure Children Hepatic encephalopathy Liver transplantation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Gastroenterology Pediatrics, Perinatology and Child Health |
