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.
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: P Durand; D Debray; R Mandel; C Baujard; S Branchereau; F Gauthier; E Jacquemin; D Devictor Journal: J Pediatr Date: 2001-12 Impact factor: 4.406
Authors: H Bonatti; P Muiesan; S Connelly; A Baker; G Mieli-Vergani; P Gibbs; N Heaton; M Rela Journal: J Pediatr Surg Date: 1997-03 Impact factor: 2.545
Authors: Michael R Narkewicz; Dominic Dell Olio; Saul J Karpen; Karen F Murray; Kathy Schwarz; Nada Yazigi; Song Zhang; Steven H Belle; Robert H Squires Journal: J Pediatr Date: 2009-07-29 Impact factor: 4.406
Authors: E S Woodle; J M Millis; S K So; S V McDiarmid; R W Busuttil; C O Esquivel; P F Whitington; J R Thistlethwaite Journal: Transplantation Date: 1998-09-15 Impact factor: 4.939
Authors: Kathleen B Schwarz; Dominic Dell Olio; Steven J Lobritto; M James Lopez; Norberto Rodriguez-Baez; Nada A Yazigi; Steven H Belle; Song Zhang; Robert H Squires Journal: J Pediatr Gastroenterol Nutr Date: 2014-11 Impact factor: 2.839
Authors: Samar H Ibrahim; Maureen M Jonas; Sarah A Taylor; Luz Helena Gutierrez Sanchez; Jaqueline L Wolf; Shikha S Sundaram Journal: Hepatology Date: 2020-03-18 Impact factor: 17.425
Authors: Michael R Narkewicz; Simon Horslen; Regina M Hardison; Benjamin L Shneider; Norberto Rodriguez-Baez; Estella M Alonso; Vicky L Ng; Mike A Leonis; Kathleen M Loomes; David A Rudnick; Philip Rosenthal; Rene Romero; Girish C Subbarao; Ruosha Li; Steven H Belle; Robert H Squires Journal: Clin Gastroenterol Hepatol Date: 2018-04-30 Impact factor: 11.382
Authors: James E Squires; David A Rudnick; Regina M Hardison; Simon Horslen; Vicky L Ng; Estella M Alonso; Steven H Belle; Robert H Squires Journal: Hepatology Date: 2018-11-01 Impact factor: 17.425