Hepatitis A acute liver failure: follow-up of paediatric patients in southern Brazil.
We retrospectively analysed 33 children and adolescents who had been hospitalized in a liver transplant unit within the previous 10 years for acute liver failure (ALF). The patients' age varied between 2 months and 15 years of age (median 6.2 +/- 5.3), and 21 (63%) were male. Thirteen patients (39%) were immunoglobulin-M anti-hepatitis A virus (HAV) sero-positive. Eleven cases (33%) had an undetermined aetiology. The 13 children with HAV ALF were between 17 months and 15.6 years of age (median 5.8 +/- 4.6) and eight were male (61.5%). All were on a list for urgent liver transplant. Of these, five (38%) died while waiting for a liver. Only one patient recovered spontaneously. Seven patients received a liver transplant; three died in the immediate postoperative period and one died 45 days after transplant. Three children are alive 1, 2 and 5 years after transplant. We conclude that HAV was the most frequent cause of ALF, which had high mortality even when a liver transplant was possible. The results support universal HAV vaccination in this area.
Pediatric Liver Transplant Unit, Hospital de Clínicas, Porto Alegre, Brazil. cristinatarga@terra.com.br
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Vieira
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Kieling
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Silveira
D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000276:immunology / Q000401:mortality; D035922:Hepatitis A Antibodies / Q000097:blood; D030041:Hepatitis A virus; D006801:Humans; D007223:Infant; D017114:Liver Failure, Acute / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies
D035922:Hepatitis A Antibodies