Navigation Links
Study examines liver transplantation after drug induced acute liver failure
Date:7/1/2009

Liver transplantation offers a good chance for survival for patients with drug induced acute liver failure, however, certain pre-transplant factors are associated with worse outcomes. Patients who are on life support, who have elevated serum creatinine, and children whose liver failure was caused by antiepileptic drugs did not fare as well after transplantation. These findings are in the July issue of Liver Transplantation, a journal published by John Wiley & Sons. The article is also available online at Wiley Interscience (www.interscience.wiley.com).

Drug induced acute liver failure is very rare, but can be life-threatening. Acetaminophen is the most common cause, accounting for nearly half of cases in adults, but other drugs can also be responsible. For patients who are unlikely to recover spontaneously, liver transplantation is the only treatment.

Researchers, led by Ayse L. Mindikoglu, M.D., M.P.H. of the University of Maryland School of Medicine and VA Maryland Health Care System, examined the United Network for Organ Sharing (UNOS) database which contains information about outcomes of nearly all liver transplants performed in the U.S. since 1987. They planned to analyze all of the drugs associated with acute liver failure and subsequent liver transplantation, determine survival rates after transplantation, and develop a model that would predict the risk of death after transplantation for these patients.

They included 661 patients567 adults and 94 children under age 18--who were transplanted for drug induced acute liver failure between October 1, 1987, and December 31, 2006. For each case, they collected twenty recipient and six donor demographic and clinical variables from the database.

They found that the leading drug groups causing liver failure that required transplantation were acetaminophen (40 percent), antituberculosis drugs (8 percent), antiepileptics (7 percent) and antibiotics (6 percent). For the entire cohort of transplant recipients, median survival time was 14.4 years. One year estimated survival probabilities were 76 percent, 82 percent, 52 percent, 82 percent, and 79 percent for acetaminophen, antituberculosis, antiepileptics, antibiotics and others, respectively.

"Among the patients who had acute liver failure due to antiepileptics, one-year survival was only 27 percent in patients less than 18 years old compared to 75 percent in patients 18 years old or older," the authors report. Interestingly, these patients were least likely to be listed as status 1 and spent the most time waiting for an organ. Also, the warm and cold ischemia times were longest for this group of patients. "The relatively low survival probability persisted after controlling for these variables in multivariate analysis," the authors report. The reasons for the decreased survival in this group could not be elucidated based on the available data.

Examining the different demographic and clinical factors for each patient and donor, the researchers noted that, "elevated serum creatinine, being on life support, and drug-induced acute liver failure due to antiepileptics (at age less than 18) were found to be independent pretransplant predictors of poor survival."

Using the entire study population, the researchers developed a prognostic model which showed strong predictive ability.

An accompanying editorial by Paul B. Watkins of the Institute for Drug Safety at the Hamner Institutes of Health Sciences, Research Triangle, NC and Paul H. Hayashi of the University of North Carolina , commends the authors for adding valuable information about acute liver failure caused by drugs. In particular, "the identification of poorer outcome for children with anti-epileptic drug induced acute liver failure is intriguing and points out the need for more focused research on drug induced liver injury in pediatric populations."

Drug induced liver injury has wide implications for all of us who take and prescribe medications, they write. And they look forward to future advances in our understanding of the issue, as researchers investigate hypotheses about preventive factors and genetic predisposition.


'/>"/>

Contact: Sean Wagner
medicalnews@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Study Supports Wider Use of Statins
2. Study identifies biomarker that safely monitors tumor response to new brain cancer treatment
3. The European Association for the Study of the Liver renews publishing partnership with Elsevier
4. Study to see if video games can boost thinking skills in elderly
5. GIE: Gastrointestinal Endoscopy June issue study highlights
6. Study shows 1 in 25 deaths worldwide attributable to alcohol
7. Veterans Affairs Researchers Study Benefits of Robot for Ankle Rehabilitation
8. U-M study finds voice box can be preserved, even with the largest cancers
9. Clinical Study Data Indicates that Celliant Reduces Pain
10. Girls Overall Self-Worth Improves With Contact Lens Wear, Study Shows
11. New Study Shows that Prebiotics, as Used by Jackson GI Medical, Increases Lifespan by 33%
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are confused ... endometriosis. These women need a treatment plan to not only alleviate symptoms and ... help for preservation of fertility and ultimately achieving a pregnancy. The specialists at ...
(Date:6/25/2016)... ... 2016 , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily ... of Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures ... . Simply select a ProHand generator and drag it above media or text in ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of ... award to iHire in recognition of their exemplary accomplishments in worksite health promotion. , ... Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was ...
(Date:6/24/2016)... ... , ... June 19, 2016 is World Sickle Cell Observance Day. In an ... of holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued a ... Cell Disease (SCD) is a disorder of the red blood cells, which can cause ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... ... is now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Guerbet announced today that it has been named a ... One of 12 suppliers to receive the ... of Premier members through exceptional local customer service and ... lower costs. "We ... customer service from Premier," says Massimo Carrara , ...
(Date:6/23/2016)... June 23, 2016 Research and ... Procedure Volumes: Global Analysis (United States, China, Japan, Brazil, ... report to their offering. ... for healthcare business planners, provides surgical procedure volume data ... trends with an in-depth analysis of growth drivers and ...
(Date:6/23/2016)... The Biotechnology industry might still ... great opportunities to investors. Stock-Callers.com assesses the recent performances ... XON ), Vertex Pharmaceuticals Inc. (NASDAQ: ... ARNA ), and Regeneron Pharmaceuticals Inc. (NASDAQ: ... your complimentary trade alerts at: http://stock-callers.com/registration ...
Breaking Medicine Technology: