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Liver transplantation for acute liver failure due to toxic agent ingestion in children
Author(s) -
Akman Sezin Asik,
Cakir Murat,
Baran Masallah,
Arikan Cigdem,
Yuksekkaya Hasan Ali,
Tumgor Gokhan,
Saz Ulas Eylem,
Zeytunlu Murat,
Kilic Murat,
Aydogdu Sema
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01119.x
Subject(s) - medicine , toxic hepatitis , ingestion , toxic encephalopathy , encephalopathy , liver transplantation , hepatic encephalopathy , jaundice , liver disease , liver function , liver failure , fulminant hepatic failure , surgery , transplantation , gastroenterology , hepatitis , cirrhosis
ALF is characterized by sudden onset, impaired liver function, jaundice and encephalopathy, without previous liver disease. We analyzed the patients who underwent LT due to toxic agent induced ALF to raise community awareness about preventing the toxic agent induced ALF. Five children (three boys, two girls) underwent LT due to toxic agent ingestion. Toxic agents were mushroom poisoning (n = 2), Datura stramonium (n = 1), yellow phosphorous (n = 1) and INH (n = 1). On admission, one patient had stage IV, two had stage III and two had stage II hepatic encephalopathy but worsened during the follow‐up. One patient had renal failure, and three patients required mechanical ventilation. Three patients underwent LRLT and others from a DD. Post‐operative complications were managed by supportive managements successfully, and overall all the patients are alive (100% survival) without any organ sequelae. Although outcome of these patients are excellent, ALF may be prevented in these cases by educating the public about consuming mushrooms and toxic effects of wild plants, prohibiting fireworks and serial liver enzyme measurements after initiating INH.