Document Detail


Characterization and outcomes of young infants with acute liver failure.
MedLine Citation:
PMID:  21621221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To characterize infants aged ≤ 90 days enrolled in an international, multicenter, prospective registry of children aged < 18 years with acute liver failure (ALF).
STUDY DESIGN: The Pediatric Acute Liver Failure (PALF) Study Group collects prospective data on children from birth to 18 years. We analyzed data from infants aged ≤ 90 days enrolled in the PALF Study before May 18, 2009.
RESULTS: A total of 148 infants were identified in the PALF registry (median age, 18 days). Common etiologies of ALF were indeterminate (38%), neonatal hemochromatosis (13.6%), and herpes simplex virus (12.8%). Spontaneous survival occurred in 60% of the infants, 16% underwent liver transplantation, and 24% died without undergoing liver trsansplantation. Infants with indeterminate ALF were more likely to undergo liver transplantation than those with viral-induced ALF (P = .0002). The cumulative incidence of death without liver transplantation was higher in infants with viral ALF (64%) compared with those with neonatal hemochromatosis (16%) or indeterminate ALF (14%) (P = .0007).
CONCLUSION: ALF in young infants presents unique diagnostic considerations. Spontaneous survival is better than previously thought. Liver transplantation provides an additional option for care.
Authors:
Shikha S Sundaram; Estella M Alonso; Michael R Narkewicz; Song Zhang; Robert H Squires;
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-05-31
Journal Detail:
Title:  The Journal of pediatrics     Volume:  159     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-14     Completed Date:  2011-12-29     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  813-818.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, The Children's Hospital, University of Colorado School of Medicine, Aurora, CO, USA. sundaram.shikha@tchden.org
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MeSH Terms
Descriptor/Qualifier:
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Cholestasis / epidemiology
Hemochromatosis / congenital,  epidemiology
Hepatic Encephalopathy / epidemiology
Herpes Simplex / epidemiology
Humans
Hyperbilirubinemia / epidemiology
Infant
Infant, Newborn
International Normalized Ratio
Liver Failure, Acute / etiology,  mortality*,  surgery*
Liver Transplantation / statistics & numerical data*
Prospective Studies
Registries
gamma-Glutamyltransferase / blood
Grant Support
ID/Acronym/Agency:
M01 RR 08084/RR/NCRR NIH HHS; M01 RR00069/RR/NCRR NIH HHS; U01 DK072146/DK/NIDDK NIH HHS; U01 DK072146-04/DK/NIDDK NIH HHS; U01-DK 072146-04/DK/NIDDK NIH HHS; UL1 RR024131/RR/NCRR NIH HHS; UL1 RR02415/RR/NCRR NIH HHS; ULI RR025014-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
EC 2.3.2.2/gamma-Glutamyltransferase; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase
Investigator
Investigator/Affiliation:
Saul Karpen / ; Ruben E Quiros / ; Dominic Dell Olio / ; Deirdre Kelly / ; Robert Squires / ; Ben Schneider / ; Steven Lobritto / ; Humberto Soriano / ; Rene Romero / ; Scott Elisofon / ; Maureen Jonas / ; Vick Ng / ; Girish Subbarao / ; Kathleen Schwartz / ; Anil Dhawan / ; Nanda Kerkar / ; Sukru Emre / ; Estella Alonso / ; Brendan M McGuire / ; Martin G Martin / ; Joel E Lavine / ; Philip Rosenthal / ; John Bucuvalas / ; Nada Yazigi / ; Michael Narkewicz / ; M James Lopez / ; Simon Horslen / ; Liz Rand / ; Daniel W Thomas / ; Norberto Rodriguez-Baez / ; Karen Murray / ; David Rudnick / ; Ross Shepherd /
Comments/Corrections

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