Original Article

Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center’s experience in Turkey

Volume 27 · Issue 5 Publish Date: September 15, 2016
Figen Özçay Eda Karadağ-Öncel Zeren Barış Oğuz Canan Gökhan Moray Mehmet Haberal
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Turkish Journal of Gastroenterology

Volume 27 · Issue 5

Pages: 450-457

History

Published Online: September 15, 2016

Copyright © 2016 Figen Özçay, Eda Karadağ-Öncel, Zeren Barış, Oğuz Canan, Gökhan Moray, Mehmet Haberal

Figen Özçay
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Ankara, Turkey
Eda Karadağ-Öncel
Department of Pediatrics, Division of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
Zeren Barış
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Ankara, Turkey
Oğuz Canan
Department of Pediatrics, Divisions of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Adana, Turkey
Gökhan Moray
Department of General Surgery, Başkent University, School of Medicine, Ankara
Mehmet Haberal
Division of General Surgery, Başkent University School of Medicine, Ankara, Turkey
Özçay, F., Karadağ-Öncel, E., Barış, Z., Canan, O., Moray, G., & Haberal, M. (2016). Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center’s experience in Turkey. Turkish Journal of Gastroenterology, 27(5), 450–457. https://doi.org/10.5152/tjg.2016.16431
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Abstract

Abstract Background/Aims: Our aim was to determine the etiologies, outcomes, and prognostic indicators in children with acute liver failure. Materials and Methods: Ninety-one patients who were followed for pediatric acute liver failure (PALF) over a 15-year period were included. Patients who survived with supportive therapy were designated as Group 1, while those who died or underwent liver transplantation were designated as Group 2. Results: There were 37 (40.6%) patients in Group 1 (spontaneous recovery) and 54 (59.4%) patients in Group 2. Thirty-two patients (35.2%) underwent liver transplantation. Infectious and indeterminate causes were the most common etiologies (33% each). Among the infectious causes, hepatitis A (76%) was the most frequent. Hepatic encephalopathy grade 3-4 on admission and during follow-up and high Pediatric Risk of Mortality (PRISM) and Pediatric End-Stage Liver Disease (PELD) scores within the first 24 h were related with a poor prognosis. Group 2 had a more prolonged prothrombin time, higher international normalized ratio, more prolonged activated partial thromboplastin time (aPTT), and higher levels of total and direct bilirubin, ammonia, and lactate (for all, p<0.01). Conclusion: Infectious and indeterminate cases constituted the most common etiology of PALF, and the etiology was related to the prognosis in our series. Although high PELD and PRISM scores were related to poor prognoses, no sharp thresholds for individual laboratory tests could be elucidated. Liver transplantation was the only curative treatment for patients with poor prognoses and resulted in high survival rates (1-, 5-, and 10-yearsurvival rates of 81.3%, 81.3%, and 75%, respectively) in our study.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 27 · Issue 5
Pages 450-457
DOI 10.5152/tjg.2016.16431
History
Published Online September 15, 2016
Copyright
Copyright (c) 2016 Figen Özçay, Eda Karadağ-Öncel, Zeren Barış, Oğuz Canan, Gökhan Moray, Mehmet Haberal
Affiliations
Figen Özçay
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Ankara, Turkey
Eda Karadağ-Öncel
Department of Pediatrics, Division of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
Zeren Barış
Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Ankara, Turkey
Oğuz Canan
Department of Pediatrics, Divisions of Gastroenterology, Hepatology, and Nutrition, Başkent University School of Medicine, Adana, Turkey
Gökhan Moray
Department of General Surgery, Başkent University, School of Medicine, Ankara
Mehmet Haberal
Division of General Surgery, Başkent University School of Medicine, Ankara, Turkey
Cite this Article
Özçay, F., Karadağ-Öncel, E., Barış, Z., Canan, O., Moray, G., & Haberal, M. (2016). Etiologies, outcomes, and prognostic factors of pediatric acute liver failure: A single center’s experience in Turkey. Turkish Journal of Gastroenterology, 27(5), 450–457. https://doi.org/10.5152/tjg.2016.16431
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