[Clinical experience in treatment of Amanita phalloides poisoning].
BACKGROUND
The management of patients suffering from Amanita Phalloides poisoning (APP) may be very challenging. Furthermore, the treatment often includes depurative techniques and Orthotopic Liver Transplantation (OLTx) must be started timely to be effective. We report our experience in severe APP treatment.


METHODS
We retrospectively evaluated five patients suffering from APP and hospitalized within our Intensive Care Unit, assessing different kinds of treatment: two different dialytic techniques, namely Continuous Renal Replacement Therapy (CRRT), and Charcoal Plasmaperfusion (CRRT+CPP), and OLTx.


RESULTS
Two patients treated with CRRT+CPP, one patient treated with CRRT only and the patient treated by OLTx recovered. One patient, undergoing CRRT only, died after 14 days of treatment. During the CRRT+CPP treatment no relevant complication occurred. The transplanted patient received dialytic treatment for 7 days after transplantation in order to support renal function impairment and to enhance liver function recovery.


CONCLUSIONS
Clinical management of patients suffering from APP requires multi-disciplinary intervention; therefore it is recommended to treat these patients in an Intensive Care Unit with specialized nephrological and toxicological consultancy, in collaboration with an organ transplantation team. In the near future we wish to associate dialytic treatment with a bioartificial liver device, which could bridge the time gap to liver transplantation.
Splendiani
G
G
Cattedra di Nefrologia, Universita' di Roma "Tor Vergata", Italy.
Mazzarella
V
V
Zazzaro
D
D
Dipietrantonio
P
P
Vega
A
A
Cipriani
S
S
Casciani
C U
CU
D000208:Acute Disease; D000328:Adult; D000545:Amanita; D019090:Case Management; D003131:Combined Modality Therapy; D003422:Critical Care; D005260:Female; D006464:Hemoperfusion; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000150:complications / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D012189:Retrospective Studies