Approaches to acute liver failure in children
| Autor: | Paul Cheeseman, Giorgina Mieli-Vergani, Anil Dhawan |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Antifungal Agents medicine.medical_treatment Encephalopathy Autoimmune hepatitis Liver transplantation Sensitivity and Specificity Enteral Nutrition medicine Coagulopathy Humans International Normalized Ratio Child Intensive care medicine Hepatic encephalopathy Transplantation business.industry digestive oral and skin physiology Antibiotic Prophylaxis Liver Failure Acute Prognosis medicine.disease Liver Transplantation Surgery ROC Curve Supportive psychotherapy Pediatrics Perinatology and Child Health Prothrombin Time Etiology business |
| Zdroj: | Pediatric Transplantation. 8:584-588 |
| ISSN: | 1399-3046 1397-3142 |
| Popis: | Acute liver failure (ALF) is a rare but often fatal disorder in childhood. Its aetiology includes infections, toxins, metabolic disorders, infiltrative diseases, autoimmune hepatitis, ischaemia, irradiation damage, but in a high proportion of cases it remains unknown. In contrast to adults, in children with ALF hepatic encephalopathy can be a late event, and may not develop at all, despite a lethal outcome, particularly in infants. Children with ALF should be managed in experienced centres with facilities for liver transplantation. Transplantation should be offered only if the underlying disease is treatable by liver replacement and if the prognosis of transplant is better than that of the underlying disease, as in many cases of ALF the liver has the potential to recover with supportive treatment, if the child is kept alive and stable long enough. Universally accepted criteria for listing for transplantation have not been defined as yet. In our centre, maximum INR, bilirubin level, and white cell count, together with age have proven to be reliable predictors of outcome. Future efforts in the management of ALF should concentrate on designing efficient supportive therapy and specific treatments to provide effective non-transplant therapeutic options. |
| Databáze: | OpenAIRE |
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