کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3314767 | 1211216 | 2007 | 8 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Amanita phalloides poisoning: Reassessment of prognostic factors and indications for emergency liver transplantation Amanita phalloides poisoning: Reassessment of prognostic factors and indications for emergency liver transplantation](/preview/png/3314767.png)
Background/AimsAmanita phalloides poisoning is an uncommon cause of acute liver failure with an especially rapid course. The aim of this study was to re-assess transplantation criteria in patients with mushroom poisoning.MethodsTwenty-seven patients admitted for Amanita phalloides poisoning were studied. Previously reported transplantation criteria, including the recent Ganzert’s criteria, were tested retrospectively.ResultsThe rate of fatal intoxication (death and/or transplantation) was 8/27 (30%). An interval between ingestion and diarrhea <8 h was a very early predictor of a fatal outcome (accuracy of 78%). Later on, non-paracetamol and paracetamol King’s College criteria were superior to Clichy’s and Ganzert’s criteria (accuracy of 100% compared to 85% and 85%, respectively). Encephalopathy and renal insufficiency were not constant in the fatal intoxication group. Prothrombin index below 10% 4 days or more after ingestion had a 100% accuracy for predicting a fatal outcome.ConclusionsLiver transplantation should be strongly considered in patients with an interval between ingestion and diarrhea <8 h. Encephalopathy should not be an absolute prerequisite for deciding transplantation. From day 4 after ingestion, prothrombin index lower than 10% (≈INR of 6) alone is a reliable tool for deciding emergency transplantation.
Journal: Journal of Hepatology - Volume 46, Issue 3, March 2007, Pages 466–473