title: Liver transplantation for acute liver failure due to toxic agent ingestion in children.
abstract: ALF is characterized by sudden onset, impaired liver function, jaundice and encephalopathy, without previous liver disease. We analyzed the patients who underwent LT due to toxic agent induced ALF to raise community awareness about preventing the toxic agent induced ALF. Five children (three boys, two girls) underwent LT due to toxic agent ingestion. Toxic agents were mushroom poisoning (n = 2), Datura stramonium (n = 1), yellow phosphorous (n = 1) and INH (n = 1). On admission, one patient had stage IV, two had stage III and two had stage II hepatic encephalopathy but worsened during the follow-up. One patient had renal failure, and three patients required mechanical ventilation. Three patients underwent LRLT and others from a DD. Post-operative complications were managed by supportive managements successfully, and overall all the patients are alive (100% survival) without any organ sequelae. Although outcome of these patients are excellent, ALF may be prevented in these cases by educating the public about consuming mushrooms and toxic effects of wild plants, prohibiting fireworks and serial liver enzyme measurements after initiating INH.
authors.affiliation: Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Bornova, Izmir, Turkey.
authors.forename: Sezin Asik
authors.initials: SA
authors.lastname: Akman
authors.forename: Murat
authors.initials: M
authors.lastname: Cakir
authors.forename: Masallah
authors.initials: M
authors.lastname: Baran
authors.forename: Cigdem
authors.initials: C
authors.lastname: Arikan
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Yuksekkaya
authors.forename: Gokhan
authors.initials: G
authors.lastname: Tumgor
authors.forename: Eylem Ulas
authors.initials: EU
authors.lastname: Saz
authors.forename: Ulas Eylem
authors.initials: UE
authors.lastname: Saz
authors.forename: Murat
authors.initials: M
authors.lastname: Zeytunlu
authors.forename: Murat
authors.initials: M
authors.lastname: Kilic
authors.forename: Sema
authors.initials: S
authors.lastname: Aydogdu
mesh_terms: D000293:Adolescent; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D007538:Isoniazid / Q000506:poisoning*; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D009145:Mushroom Poisoning / Q000150:complications*; D010758:Phosphorus / Q000506:poisoning*; D016896:Treatment Outcome
chemical_list: D010758:Phosphorus; D007538:Isoniazid