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Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

ABSTRACT: The long-term clinical outcomes in initial survivors with acute liver failure (ALF) are not well known. The aim of this study was to provide an overview of the 2-year clinical outcomes among initial survivors and liver transplant (LT) recipients that were alive 3 weeks after enrolment in the Acute Liver Failure Study Group (ALFSG).Outcomes in adult ALFSG patients that were enrolled between 1998 and 2010 were reviewed.Two-year patient survival was significantly higher in the 262 LT recipients (92.4%) compared to the 306 acetaminophen (APAP) spontaneous survivors (SS) (89.5%) and 200 non-APAP SS (75.5%) (P < 0.0001). The causes of death were similar in the three groups but the time to death was significantly longer in the LT recipients (P < 0.0001). Independent predictors of 2-year mortality in the APAP group were a high serum phosphate level and patient age (c-statistic = 0.65 (0.54, 0.76)), patient age and days from jaundice to ALF onset in the non-APAP group (c-statistic = 0.69 (0.60, 0.78)), and patient age, days from jaundice, and higher coma grade in the LT recipients (c-statistic = 0.74 (0.61, 0.87)). The LT recipients were significantly more likely to be employed and have a higher educational level (P < 0.05).Two-year outcomes in initial survivors of ALF are generally good but non-APAP patients have a significantly lower survival which may relate to pre-existing medical comorbidities. Spontaneous survivors with APAP overdose experience substantial morbidity during follow-up from ongoing psychiatric and substance abuse issues.

SUBMITTER: Fontana RJ

PROVIDER: S-EPMC4291312 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

Fontana Robert J RJ Ellerbe Caitlyn C Durkalski Valerie E VE Rangnekar Amol A Reddy Rajender K RK Stravitz Todd T McGuire Brendan B Davern Timothy T Reuben Adrian A Liou Iris I Fix Oren O Ganger Daniel R DR Chung Raymond T RT Schilsky Mike M Han Steven S Hynan Linda S LS Sanders Corron C Lee William M WM

Liver international : official journal of the International Association for the Study of the Liver 20140728 2

<h4>Background & aims</h4>The long-term clinical outcomes in initial survivors with acute liver failure (ALF) are not well known. The aim of this study was to provide an overview of the 2-year clinical outcomes among initial survivors and liver transplant (LT) recipients that were alive 3 weeks after enrolment in the Acute Liver Failure Study Group (ALFSG).<h4>Methods</h4>Outcomes in adult ALFSG patients that were enrolled between 1998 and 2010 were reviewed.<h4>Results</h4>Two-year patient surv ...[more]

PMID: 25039930

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Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

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Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

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