Premium
Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning
Author(s) -
Faybik Peter,
Hetz Hubert,
Baker Amir,
Bittermann Clemens,
Berlakovich Gabriela,
Werba Alois,
Krenn ClausGeorg,
Steltzer Heinz
Publication year - 2003
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1034/j.1478-3231.23.s.3.8.x
Subject(s) - medicine , amanita phalloides , extracorporeal , mushroom poisoning , liver transplantation , hemoperfusion , surgery , dialysis , ingestion , albumin , transplantation , hemodialysis , poison control , botany , environmental health , biology
Background: Ingestion of Amanita phalloides is the most common cause of lethal mushroom poisoning. The relative late onset of symptoms is a distinct diagnostic feature of Amanita intoxication and also the main reason of failure for extracorporeal removal of Amanita ‐specific toxins from the gut and circulation. Patients and methods: Extracorporeal albumin dialysis (ECAD) has been used on six consecutive patients admitted after A. phalloides poisoning with acute liver failure (ALF). Results: Six patients, with mean age of 46 years (range: 9–70 years), underwent one to three ECAD treatments. The mean time from mushroom ingestion until the first ECAD treatment was 76 h. Two patients regenerated spontaneously under ECAD treatment and orthotopic liver transplantation (OLT) could be avoided. Two patients were successfully bridged to OLT and one patient died because of cerebral herniation. One patient was treated with ECAD immediately after OLT because of the graft dysfunction and survived without re‐transplantation. Conclusion: ECAD appeared to be a successful treatment perspective in supporting liver regeneration or in sufficient bridging to OLT and also in treatment of graft dysfunction after OLT in patients with A. phalloides poisoning.