TY - JOUR
T1 - Acute liver failure in children
T2 - The first 348 patients in the pediatric acute liver failure study group
AU - Squires, Robert H.
AU - Shneider, Benjamin L.
AU - Bucuvalas, John
AU - Alonso, Estella
AU - Sokol, Ronald J.
AU - Narkewicz, Michael R.
AU - Dhawan, Anil
AU - Rosenthal, Philip
AU - Rodriguez-Baez, Norberto
AU - Murray, Karen F.
AU - Horslen, Simon
AU - Martin, Martin G.
AU - Lopez, M. James
AU - Soriano, Humberto
AU - McGuire, Brendan M.
AU - Jonas, Maureen M.
AU - Yazigi, Nada
AU - Shepherd, Ross W.
AU - Schwarz, Kathleen
AU - Lobritto, Steven
AU - Thomas, Daniel W.
AU - Lavine, Joel E.
AU - Karpen, Saul
AU - Ng, Vicky
AU - Kelly, Deirdre
AU - Simonds, Nancy
AU - Hynan, Linda S.
N1 - Funding Information:
Supported by NIH grant RO1-DK58369-01; and by M01-RR00069, M01-RR00037, and M01 RR08084 from the General Clinical Research Center Program of the National Center for Research Resources of the NIH.
PY - 2006/5
Y1 - 2006/5
N2 - Objectives: To determine short-term outcome for children with acute liver failure (ALF) as it relates to cause, clinical status, and patient demographics and to determine prognostic factors. Study design: A prospective, multicenter case study collecting demographic, clinical, laboratory, and short-term outcome data on children from birth to 18 years with ALF. Patients without encephalopathy were included if the prothrombin time and international normalized ratio remained ≥20 seconds and/or >2, respectively, despite vitamin K. Primary outcome measures 3 weeks after study entry were death, death after transplantation, alive with native liver, and alive with transplanted organ. Results: The cause of ALF in 348 children included acute acetaminophen toxicity (14%), metabolic disease (10%), autoimmune liver disease (6%), non-acetaminophen drug-related hepatotoxicity (5%), infections (6%), other diagnosed conditions (10%); 49% were indeterminate. Outcome varied between patient sub-groups; 20% with non-acetaminophen ALF died or underwent liver transplantation and never had clinical encephalopathy. Conclusions: Causes of ALF in children differ from in adults. Clinical encephalopathy may not be present in children. The high percentage of indeterminate cases provides an opportunity for investigation.
AB - Objectives: To determine short-term outcome for children with acute liver failure (ALF) as it relates to cause, clinical status, and patient demographics and to determine prognostic factors. Study design: A prospective, multicenter case study collecting demographic, clinical, laboratory, and short-term outcome data on children from birth to 18 years with ALF. Patients without encephalopathy were included if the prothrombin time and international normalized ratio remained ≥20 seconds and/or >2, respectively, despite vitamin K. Primary outcome measures 3 weeks after study entry were death, death after transplantation, alive with native liver, and alive with transplanted organ. Results: The cause of ALF in 348 children included acute acetaminophen toxicity (14%), metabolic disease (10%), autoimmune liver disease (6%), non-acetaminophen drug-related hepatotoxicity (5%), infections (6%), other diagnosed conditions (10%); 49% were indeterminate. Outcome varied between patient sub-groups; 20% with non-acetaminophen ALF died or underwent liver transplantation and never had clinical encephalopathy. Conclusions: Causes of ALF in children differ from in adults. Clinical encephalopathy may not be present in children. The high percentage of indeterminate cases provides an opportunity for investigation.
UR - http://www.scopus.com/inward/record.url?scp=33646946176&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2005.12.051
DO - 10.1016/j.jpeds.2005.12.051
M3 - Article
AN - SCOPUS:33646946176
SN - 0022-3476
VL - 148
SP - 652-658.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 5
ER -