AIMS: The purpose of this study is to describe the incidence and presenting features of patients with acute liver failure (ALF) due to ischemic hepatitis and the prognostic factors associated with short (three-week) and long-term outcomes. METHODS: Retrospective cohort analysis of adult patients enrolled in the Acute Liver Failure Study Group between 1998 and 2008 with ALF due to ischemic hepatitis. Predictors of adverse outcomes three weeks after presentation were identified by univariate and multivariate analysis. RESULTS: Ischemic hepatitis accounted for 51 (4.4%) of the 1147 ALF patients enrolled. Mean age was 50 years, 63% were female, and only 31% had known heart disease before presentation. However, a cardiopulmonary precipitant of hepatic ischemia was identified in 69%. Three-week spontaneous survival was 71%, two patients (4%) underwent liver transplantation, and the remaining 13 patients (25%) died of multi-organ failure. Adverse outcomes were more frequent in subjects with higher admission phosphate levels (HR 1.3, 95% CI 1.1-1.6, P = 0.008) and in subjects with grade 3/4 encephalopathy at presentation (HR: 8.4, 95% CI 1.1-66.5, P = 0.04). Nineteen of the 28 short-term survivors (68%) were still alive at a median follow-up of 3.7 years whereas nine (32%) others had died at a median follow-up of 2 months. CONCLUSIONS: A higher admission serum phosphate level and more advanced encephalopathy are associated with a lower likelihood of short-term survival of hospitalized patients with ALF due to ischemic hepatitis. Long-term outcomes are largely determined by underlying cardiovascular morbidity and mortality.
AIMS: The purpose of this study is to describe the incidence and presenting features of patients with acute liver failure (ALF) due to ischemic hepatitis and the prognostic factors associated with short (three-week) and long-term outcomes. METHODS: Retrospective cohort analysis of adult patients enrolled in the Acute Liver Failure Study Group between 1998 and 2008 with ALF due to ischemic hepatitis. Predictors of adverse outcomes three weeks after presentation were identified by univariate and multivariate analysis. RESULTS:Ischemic hepatitis accounted for 51 (4.4%) of the 1147 ALFpatients enrolled. Mean age was 50 years, 63% were female, and only 31% had known heart disease before presentation. However, a cardiopulmonary precipitant of hepatic ischemia was identified in 69%. Three-week spontaneous survival was 71%, two patients (4%) underwent liver transplantation, and the remaining 13 patients (25%) died of multi-organ failure. Adverse outcomes were more frequent in subjects with higher admission phosphate levels (HR 1.3, 95% CI 1.1-1.6, P = 0.008) and in subjects with grade 3/4 encephalopathy at presentation (HR: 8.4, 95% CI 1.1-66.5, P = 0.04). Nineteen of the 28 short-term survivors (68%) were still alive at a median follow-up of 3.7 years whereas nine (32%) others had died at a median follow-up of 2 months. CONCLUSIONS: A higher admission serum phosphate level and more advanced encephalopathy are associated with a lower likelihood of short-term survival of hospitalized patients with ALF due to ischemic hepatitis. Long-term outcomes are largely determined by underlying cardiovascular morbidity and mortality.
Authors: Frank V Schiødt; Jody Balko; Michael Schilsky; M Edwyn Harrison; Annelise Thornton; William M Lee Journal: Hepatology Date: 2003-03 Impact factor: 17.425
Authors: Valentin Fuhrmann; Nikolaus Kneidinger; Harald Herkner; Gottfried Heinz; Mariam Nikfardjam; Anja Bojic; Peter Schellongowski; Bernhard Angermayr; Reinhard Kitzberger; Joanna Warszawska; Ulrike Holzinger; Peter Schenk; Christian Madl Journal: Intensive Care Med Date: 2009-06-09 Impact factor: 17.440
Authors: Kimberly A Forde; K Rajender Reddy; Andrea B Troxel; Corron M Sanders; William M Lee Journal: Clin Gastroenterol Hepatol Date: 2009-06-23 Impact factor: 11.382
Authors: Elizabeth W Jackson; Steven Zacks; Sandra Zinn; John Ryan; Mark W Johnson; David A Gerber; Kenneth Andreoni; Jeffrey H Fair; Roshan Shrestha; Michael W Fried Journal: Liver Transpl Date: 2002-10 Impact factor: 5.799
Authors: Dean W Roberts; William M Lee; Jack A Hinson; Shasha Bai; Christopher J Swearingen; R Todd Stravitz; Adrian Reuben; Lynda Letzig; Pippa M Simpson; Jody Rule; Robert J Fontana; Daniel Ganger; K Rajender Reddy; Iris Liou; Oren Fix; Laura P James Journal: Clin Gastroenterol Hepatol Date: 2016-09-15 Impact factor: 11.382
Authors: K Rajender Reddy; Caitlyn Ellerbe; Michael Schilsky; R Todd Stravitz; Robert J Fontana; Valerie Durkalski; William M Lee Journal: Liver Transpl Date: 2016-04 Impact factor: 5.799
Authors: Robert J Fontana; Caitlyn Ellerbe; Valerie E Durkalski; Amol Rangnekar; Rajender K Reddy; Todd Stravitz; Brendan McGuire; Timothy Davern; Adrian Reuben; Iris Liou; Oren Fix; Daniel R Ganger; Raymond T Chung; Mike Schilsky; Steven Han; Linda S Hynan; Corron Sanders; William M Lee Journal: Liver Int Date: 2014-07-28 Impact factor: 5.828
Authors: Shannan R Tujios; Linda S Hynan; Miguel A Vazquez; Anne M Larson; Emmanuel Seremba; Corron M Sanders; William M Lee Journal: Clin Gastroenterol Hepatol Date: 2014-07-11 Impact factor: 11.382
Authors: James L Weemhoff; Benjamin L Woolbright; Rosalind E Jenkins; Mitchell R McGill; Matthew R Sharpe; Jody C Olson; Daniel J Antoine; Steven C Curry; Hartmut Jaeschke Journal: Liver Int Date: 2016-08-06 Impact factor: 5.828