Acute liver failure mortality in Uruguay
DOI:
https://doi.org/10.35954/SM2018.37.1.3Keywords:
Liver Failure, Acute; Liver TransplantationAbstract
Introduction: acute liver failure is a syndrome characerized by the development of a coagulopathy and encephalopathy in patients without a previous hepatopathy.
Objective: to identify factors associated to acute liver failure mortality in Uruguay.
METHODS: Retrospective analysis of 33 adult patients admitted due to an acute liver failure in the Liver Transplant National Program during the 2009 – 2017 period.
RESULTS: Global mortality was 51,5%, 71% of which corresponded to transplant patients and 46% to non transplant individuals. Deceased patients showed a higher MELD, a grade III – IV encephalopathy percentage and time of referral to the TH center than those who survived. Patients who never met the TH criteria (N = 4) had MELD values (25 ± 4) and referral time (5.3 ± 6.0 days) lower than the rest of the patients, all of whom survived. Patients who were too ill to enter the list (N = 7) had MELD values (40 ± 6) and referral time (29.5 ± 25.5 days) higher than the rest of the patients, all of whom died.
CONCLUSION: Acute liver failure in Uruguay presents a high mortality linked to the delay in referral to the Liver Transplant center, the MELD score and encephalopathy. The delay in the availability of organs can bear an influence in it.
Downloads
Metrics
References
(1) EASL Clinical Practical Guidelines on the man-agement of acute (fulminant) liver failure. J Hepatol 2017; 66(5):1047-81.
(2) Hoofnagle JH, Carithers RL, Shapiro C, Ascher N. Fulminant hepatic failure: summary of a work-shop. Hepatology 1995; 21:240-252.
(3) Lee WM, Squires RH, Nyberg SL, Doo E, Hoofnagle JH. Acute liver failure: Summary of a workshop. Hepatology 2008; 47(4):1401-15.
(4) Bernal W, Auzinger G, Dhawan a, Wendon J. Acute liver failure. Lancet 2010; 2010;376:190-201.
(5) Khashab M, Tector AJ, Kwo PY. Epidemiology of Acute Liver Failure. Curr Gastroenterol Rep 2007, 9:66-73.
(6) Escorsell A, Mas A, de la Mata M. Acute liver failure in Spain: Analysis of 267 cases. Liver Transpl 2007; 13:1389-95.
(7) Lee WM, Stravitz RT, Larson AM. Introduction to the revised American Association for the Study of Liver Diseases position paper on acute liver fail-ure 2011. Hepatology 2012; 55(3):965-7.
(8) Bernal W, Hyyrylainen A, Gera A, Audimoolam VK, McPhail MJW, Auzinger G, et al. Lessons from look-back in acute liver failure? A single centre expe-rience of 3300 patients. J Hepatol 2013; 59(1):74-80.
(9) Ostapowicz G, Fontana RJ, Schiodt F V, Larson A, Davern TJ, Han SH et al. Results of a Prospective Study of Acute Liver Failure at 17 Tertiary care centers in the United States. Ann Intern Med 2002; (15):947-55.
(10) Germani G, Theocharidou E, Adam R, Karam V, Wendon J, O’Grady J, et al. Liver transplantation for acute liver failure in Europe: Outcomes over 20 years from the ELTR database. J Hepatol 2012; 57(2):288-96.
(11) 2009 Annual Report of the US Organ Procure-ment Transplant Network and Scientific Registry of Transplant Recipient; Transplant data 1999-2008. Disponible en: http://optn.transplant.hrsa.gov/ar2009. [Consulta 18/11/2017].
(12) Mendizabal M, Marciano S, Videla MG, Anders M, Zerega A, Balderramo DC, et al. Changing Etiologies and Outcomes of Acute Liver Failure: Perspectives from 6 Transplant Centers in Argentina. Liver Transplant 2014; 20:483-9.
(13) Oketani M, Ido A, Tsubouchi H. Changing eti-ologies and outcomes of acute liver failure: A perspective from Japan. J Gastroenterol Hepatol 2007; 22: 676-682.
(14) Khuroo MS, Kamili S. Aetiology and prognos-tic factors in acute liver failure in India. J Viral Hepat 2003; 10:224-231.
(15) Mudawi HM, Yousif BA. Fulminant hepatic failure in an African setting: etiology, clinical course, and pre-dictors of mortality. Dig Dis Sci 2007; 52:3266-3269.
(16) O’Grady J, Alexander G, Hayllar K, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989; 97:439-445.
(17) Shukla A, Vadeyar H, Rela M, Shah S. Liver Transplantation: East versus West. J Clin Exp Hepatol 2013; 3(3):243-53.
(18) Brandsœter B, Höckerstedt K, Friman S, Ericzon BG, Kirkegaard P, Isoniemi H, et al. Fulmi-nant hepatic failure: Outcome after listing for highly urgent liver transplantation - 12 Years experience in the Nordic countries. Liver Transplant 2002; 8(11):1055-62.
(19) Barshes NR, Lee TC, Balkrishnan R, Karpen SJ, Carter BA, Goss JA. Risk Stratification of Adult Patients Undergoing Orthotopic Liver Transplanta-tion for Fulminant Hepatic Failure. Transplantation 2006; 81:195-201.
(20) Bernal W, Cross TJ, Auzinger G, Sizer E, Heneghan MA, Bowles M, et al. Outcome after wait listing for emergency liver transplantation in acute liver failure: a single centre experience. J Hepatol 2009; 50: 306-313.
(21) Jin YJ, Lim YS, Han S, Lee HC, Hwang S, Lee SG. Predicting survival after living and deceased donor liver transplantation in adult patients with acute liver failure. J Gastroenterol 2012; 47(10):1115-1124.
(22) Yuan D. Adult-to-adult living donor liver transplantation for acute liver failure in China. World J Gastroenterol 2012; 18(48):7234.
(23) Datos de libre acceso del Banco Mundial. Acceso abierto y gratuito a datos sobre el desarrollo en el mundo. Disponible en: https://datos.banco-mundial.org/ [Consulta 15/11/2017].
(24) Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy - Definition, nomenclature, diagnosis, and quantification: Final report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 2002; 35:716-721.
(25) O’Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993; 342:273-275.
(26) Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P, et al. Model for end-stage liv-er disease (MELD) and allocation of donor livers. Gastroenterology 2003; 124(1):91-6.
(27) Ministerio de Salud. Uruguay. Disponible en: www.msp.gub.uy/publicacón/programa-nacio-nal-de-vacunaciones [Consulta 16/08/2017].
(28) JI H. III Reunión de consenso de la Sociedad Española de Trasplante Hepático (SETH). Hepatitis C, trasplante hepático de donante vivo, calidad de los injertos hepáticos y calidad de los programas de trasplante hepático. Gastroenterol Hepatol 2011; 34(9):641-59.
(29) Newsletter-Transplante Iberoamérica 2016 / www.stalyc.net/es/registros. Disponible en: www.stalyc.net [Consulta 15/11/2017].
(30) Registro Donantes INDT. Estadisticas Y Regis-tro Nacional De Donantes. Evolucion De Los Registros Periodo 2005- 2014. Disponible en www.indt.gub.uy. 2014. [Consulta 15/11/2017].
(31) Gane E, McCall J, Streat S, Gunn K, Yeong ML FS et al. Liver Transplantation in New Zealand: the first four years. N Z Med J 2002; 115(1159):1-13.
(32) McCaughan GW, Munn SR. Liver transplanta-tion in Australia and New Zealand. Liver Transplant 2016; 22(6):830-8.
(33) Iqbal M, Elrayah EA, Traynor O, McCormick PA. Liver transplantation in Ireland. Liver Transplant 2016; 22(7):1014-8.
(34) Scandiatransplant. Official Scandiatransplant for-ms and schemes. Disponible en: www.scandiatrans-plant.org/organallocation/NLTG_Exchange_pay-back_rules_01_dec_2016.pdf. [Consulta 15/11/2017]
(35) Park SJ, Lim YS, Hwang S, Heo NY, Lee HC, Suh DJ, et al. Emergency adult to adult living donor liver transplantation for acute liver failure in a hepatitis B virus endemic area. Hepatology 2010; 51:903-11.
Published
How to Cite
Issue
Section
License
Until 2024 we use the Creative Commons Attribution/NonCommercial Attribution 4.0 International License https://creativecommons.org/licenses/by-nc/4.0/deed.es. Which states that: you are free to share, copy and redistribute the material in any medium or format, as well as to adapt, remix, transform and build upon the material. Under the following terms:
Attribution: you must give proper credit , provide a link to the license, and indicate if changes have been made . You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is endorsed by the licensor.
NonCommercial: you may not use the material for commercial purposes.
As of 2025 authors retain their copyright and assign to the journal the right of first publication of their work, which shall simultaneously be subject to the license https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es that permits sharing, copying and redistribution of the material in any medium or format provided that initial publication in this journal is indicated. Adapt, remix, transform and build upon the material. If you remix, transform, or build from the material, you must distribute your contribution under the same license as the original and may not make use of the material for commercial purposes.
Under the following terms:
1. Attribution: you must give proper credit, provide a link to the license, and indicate whether changes have been made. You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is endorsed by the licensor.
2. NonCommercial: you may not use the material for commercial purposes.
3. ShareAlike: if you remix, transform or build upon the material, you must distribute your contribution under the same license as the original.
PlumX Metrics
/
