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Acute liver failure in children: They really are not just small adults: Acute liver failure in children: The first 348 patients in the Pediatric Acute Liver Failure Study Group. Squires RH Jr, Shneider BL, Bucuvalas J, Alonso E, Sokol RJ, Narkewicz, et al. J Pediatr 2006;148:652‐658.
Author(s) -
Perkins James D.
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20988
Subject(s) - medicine , acetaminophen , liver transplantation , encephalopathy , liver disease , hepatic encephalopathy , pediatrics , transplantation , prospective cohort study , cirrhosis , anesthesia
Abstract Objectives To determine short‐term outcome for children with acute liver failure (ALF) as it relates to cause, clinical status, and patient demographics and to determine prognostic factors. Study design A prospective, multicenter case study collecting demographic, clinical, laboratory, and short‐term outcome data on children from birth to 18 years with ALF. Patients without encephalopathy were included if the prothrombin time and international normalized ratio remained ≥20 seconds and/or >2, respectively, despite vitamin K. Primary outcome measures 3 weeks after study entry were death, death after transplantation, alive with native liver, and alive with transplanted organ. Results The cause of ALF in 348 children included acute acetaminophen toxicity (14%), metabolic disease (10%), autoimmune liver disease (6%), non‐acetaminophen drug‐related hepatotoxicity (5%), infections (6%), other diagnosed conditions (10%); 49% were indeterminate. Outcome varied between patient sub‐groups; 20% with non‐acetaminophen ALF died or underwent liver transplantation and never had clinical encephalopathy. Conclusions Causes of ALF in children differ from in adults. Clinical encephalopathy may not be present in children. The high percentage of indeterminate cases provides an opportunity for investigation. (J Pediatr 2006;148:652‐658.)