Liver transplantation for acute liver failure due to toxic agent ingestion in children.
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.
Akman
Sezin Asik
SA
Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Bornova, Izmir, Turkey.
Cakir
Murat
M
Baran
Masallah
M
Arikan
Cigdem
C
Yuksekkaya
Hasan Ali
HA
Tumgor
Gokhan
G
Saz
Eylem Ulas
EU
Saz
Ulas Eylem
UE
Zeytunlu
Murat
M
Kilic
Murat
M
Aydogdu
Sema
S
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
D010758:Phosphorus; D007538:Isoniazid