Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non-acetaminophen-related fulminant hepatic failure

Yasuhiro Miyake, Yoshiaki Iwasaki, Yasuhiro Makino, Haruhiko Kobashi, Kouichi Takaguchi, Masaharu Ando, Kohsaku Sakaguchi, Yasushi Shiratori

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Aim: Many patients continue to die due to the rapid development of cerebral edema and/or multiple organ failure prior to receiving a liver transplantation. Methods: We investigated the prognostic factors associated with 1-week fatal outcomes after the diagnosis of fulminant hepatic failure, which were associated with fatal outcomes prior to receiving liver transplantation, in 104 patients with non-acetaminophen-related fulminant hepatic failure. Results: With a multivariate logistic regression analysis, age (>40 years), systemic inflammatory response syndrome (SIRS) and plasma prothrombin activities (≤10%) were significantly associated with fatal outcomes at 1 week after diagnosis in 104 patients. At the time of diagnosis, 50 patients (48%) were in a state of SIRS. Significant differences were observed between patients with and without SIRS regarding the period from the initial symptoms to the diagnosis of fulminant hepatic failure, hepatic coma grade, serum alanine aminotransferase level, serum creatinine level and plasma prothrombin activity. With a multivariate logistic regression analysis, age (>40 years), cause of fulminant hepatic failure (viral hepatitis), plasma prothrombin activity (≤10%) and no administration of protease inhibitor were significantly associated with the 1-week fatal outcomes of 50 patients with SIRS. Conclusions: Patients with SIRS exhibited hepatic failure of increased severity and SIRS may reduce the probability of receiving a liver transplantation. In order to estimate the efficacy of protease inhibitor for patients with SIRS, a prospective randomized trial is required.

Original languageEnglish
Pages (from-to)855-861
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume22
Issue number6
DOIs
Publication statusPublished - 2007

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Fatal Outcome
Acute Liver Failure
Systemic Inflammatory Response Syndrome
Liver Transplantation
Prothrombin
Protease Inhibitors
Logistic Models
Regression Analysis
Multiple Organ Failure
Hepatic Encephalopathy
Brain Edema
Liver Failure
Serum
Alanine Transaminase
Hepatitis
Creatinine

Keywords

  • Fulminant hepatic failure
  • Liver transplantation
  • Prognostic factor
  • Protease inhibitor
  • Systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non-acetaminophen-related fulminant hepatic failure. / Miyake, Yasuhiro; Iwasaki, Yoshiaki; Makino, Yasuhiro; Kobashi, Haruhiko; Takaguchi, Kouichi; Ando, Masaharu; Sakaguchi, Kohsaku; Shiratori, Yasushi.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 22, No. 6, 2007, p. 855-861.

Research output: Contribution to journalArticle

Miyake, Yasuhiro ; Iwasaki, Yoshiaki ; Makino, Yasuhiro ; Kobashi, Haruhiko ; Takaguchi, Kouichi ; Ando, Masaharu ; Sakaguchi, Kohsaku ; Shiratori, Yasushi. / Prognostic factors for fatal outcomes prior to receiving liver transplantation in patients with non-acetaminophen-related fulminant hepatic failure. In: Journal of Gastroenterology and Hepatology (Australia). 2007 ; Vol. 22, No. 6. pp. 855-861.
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AB - Background and Aim: Many patients continue to die due to the rapid development of cerebral edema and/or multiple organ failure prior to receiving a liver transplantation. Methods: We investigated the prognostic factors associated with 1-week fatal outcomes after the diagnosis of fulminant hepatic failure, which were associated with fatal outcomes prior to receiving liver transplantation, in 104 patients with non-acetaminophen-related fulminant hepatic failure. Results: With a multivariate logistic regression analysis, age (>40 years), systemic inflammatory response syndrome (SIRS) and plasma prothrombin activities (≤10%) were significantly associated with fatal outcomes at 1 week after diagnosis in 104 patients. At the time of diagnosis, 50 patients (48%) were in a state of SIRS. Significant differences were observed between patients with and without SIRS regarding the period from the initial symptoms to the diagnosis of fulminant hepatic failure, hepatic coma grade, serum alanine aminotransferase level, serum creatinine level and plasma prothrombin activity. With a multivariate logistic regression analysis, age (>40 years), cause of fulminant hepatic failure (viral hepatitis), plasma prothrombin activity (≤10%) and no administration of protease inhibitor were significantly associated with the 1-week fatal outcomes of 50 patients with SIRS. Conclusions: Patients with SIRS exhibited hepatic failure of increased severity and SIRS may reduce the probability of receiving a liver transplantation. In order to estimate the efficacy of protease inhibitor for patients with SIRS, a prospective randomized trial is required.

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