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Eur Rev Med Pharmacol Sci. 2017 Mar;21(1 Suppl):37-45.

Liver transplantation for drug-induced acute liver failure.

Author information

1
Liver Transplant Medicine, Gastroenterological Area, Gastroenterological and Endocrino-Metabolic Sciences Department, Fondazione Policlinico Universitario Gemelli, Catholic University of the Sacred Heart, Rome, Italy. antonio.grieco@unicatt.it.

Abstract

OBJECTIVES:

To summarize the different clinical features of drug-induced acute liver failure, the diagnostic work-up, conservative management and the prognostic scores currently used to list patients for liver transplantation.

EVIDENCE AND INFORMATION SOURCES:

The current review is based on an analysis of the current literature and the caseload experience of the Authors on this topic.

STATE OF THE ART:

Drug-induced liver injury is the leading cause of acute liver failure in the adult population in Western countries, with a transplant-free survival rate of less than 50%. Main subtypes include paracetamol and idiosyncratic drug-induced injury, which differ in epidemiology, clinical course, prognosis and conservative management. In cases of a high likelihood of death, urgent hepatic transplantation is indicated, but the decision whether and when to put a patient with drug-induced acute liver failure on the list for urgent liver transplant is extremely difficult and requires constant interdisciplinary exchange and continuous updating of the clinical picture.

CONCLUSIONS:

Intensive management should be done in a clinical tertiary referral center which has a specialized team of hepatologists and a liver transplant center.

PMID:
28379596
[Indexed for MEDLINE]
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