Aetiology and outcome of acute hepatic failure in Greece: experience of two academic hospital centre

June 19, 2008

Liver Int. 2008 May 19. [Epub ahead of print]

Aetiology and outcome of acute hepatic failure in Greece: experience of two

academic hospital centres.

Koskinas J, Deutsch M, Kountouras D, Kostopanagiotou G, Arkadopoulos N,

Smyrniotis V, Rapti I, Manesis E, Archimandritis A.

Second Department of Medicine, Medical School of Athens, Hippokration General

Hospital, Athens, Greece.

Introduction: In Western countries, the most frequent aetiology of acute liver

failure (ALF) is acetaminophen overdose, while in developing countries viral

infections [hepatitis A virus and hepatitis B virus (HBV)] predominate. Aim: To

evaluate the epidemiology, clinical characteristics, outcome and prognostic

factors of survival of patients with ALF in Greece during the last 6 years.

Results: A total of 40 patients, 28 females (70%), with a median age of

37.4+/-18.6 years (range: 15-84) with ALF were studied. HBV infection was the

cause in 53% of them (compared with 74% from a previous study reported in the

early 1980s), drug toxicity in 15% and undetermined in 13%. The overall survival

was 57.5%, including 94% with and 15% without liver transplantation. Forty-five

per cent of our patients had emergency liver transplantation in European Centers

within a median time of 3.3 days (1-9) from admission. The total bilirubin level

at admission and the development of infections were found to be significantly

associated with poor outcome. Conclusions: Hepatitis B virus still remains the

most important cause of ALF in Greece, but shows a significant decrease as

compared with studies in the early 1980s. Almost half of our patients needed

emergency liver transplantation and had a very good survival rate. The other 15%

of the patients presented spontaneous survival only with intensive medical

support.?>

PMID: 18492016 [PubMed - as supplied by publisher]

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