Study examines liver transplantation after drug induced acute liv...( Liver transplantation offers a good ...),Health

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
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