title: Etiologies and outcomes of acute liver failure in a spanish community.
abstract: Previous retrospective study (1992 to 2000) performed in Spain showed that drug toxicity, viral hepatitis, and indeterminate etiology were the most prevalent causes of acute liver failure (ALF). In the last decade, there is no information about ALF in our country. For these reasons we analyze retrospectively, in a ten-year period (2000 to 2010), the presumed causes, clinical characteristics, course, and outcome of ALF in a Spanish community. Causes of ALF were indeterminate in 4 patients (24%), acute hepatitis B infection in 4 patients (24%), drug or toxic reactions in 4 patients (24%), including one case of acetaminophen overdose, followed by miscellaneous causes. The overall short-term survival (6 weeks after admission) was 65%. Liver transplantation was performed in 11 patients with a survival of 82%. Despite fulfilling criteria, 2 patients were not transplanted because of contraindications; they both died. In summary, acute hepatitis B and indeterminate cause are still being the most frequent causes of ALF in our region, and patients with ALF have an excellent chance of survival after emergency liver transplantation. Acetaminophen overdose still represents a very rare cause of ALF in our community.
authors.affiliation: Gastroenterology and Hepatology Unit, University Hospital "Marqués de Valdecilla", Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Avenida Valdecilla s/n., Santander, 39008 Cantabria, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fábrega
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Mieses
authors.forename: Alvaro
authors.initials: A
authors.lastname: Terán
authors.forename: Irene
authors.initials: I
authors.lastname: Moraleja
authors.forename: Fernando
authors.initials: F
authors.lastname: Casafont
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
authors.forename: Fernando
authors.initials: F
authors.lastname: Pons-Romero
references.citation: Lancet. 2006 Dec 23;368(9554):2195-6
references.pmid: 17189017
references.citation: Hepatology. 1986 Jul-Aug;6(4):648-51
references.pmid: 3732998
references.citation: Gastroenterology. 1989 Aug;97(2):439-45
references.pmid: 2490426
references.citation: J Gastroenterol Hepatol. 2011 Jan;26 Suppl 1:65-71
references.pmid: 21199516
references.citation: J Coll Physicians Surg Pak. 2006 Feb;16(2):112-6
references.pmid: 16499803
references.citation: Ann Intern Med. 2002 Dec 17;137(12):947-54
references.pmid: 12484709
references.citation: Best Pract Res Clin Gastroenterol. 2012 Feb;26(1):3-16
references.pmid: 22482521
references.citation: Liver Transpl. 2008 Oct;14 Suppl 2:S67-79
references.pmid: 18825677
references.citation: Liver Transpl. 2008 Oct;14 Suppl 2:S97-101
references.pmid: 18825687
references.citation: Clin Gastroenterol Hepatol. 2009 Feb;7(2):249; author reply 249
references.pmid: 18935983
references.citation: Hepatology. 2008 Apr;47(4):1401-15
references.pmid: 18318440
references.citation: J Hepatol. 2009 Feb;50(2):306-13
references.pmid: 19070386
references.citation: Medicine (Baltimore). 1969 Mar;48(2):151-72
references.pmid: 5775820
references.citation: Mayo Clin Proc. 1985 May;60(5):289-92
references.pmid: 3921780
references.citation: Prog Liver Dis. 1970;3:282-98
references.pmid: 4908702
references.citation: Dig Dis Sci. 1991 Sep;36(9):1223-8
references.pmid: 1716546
references.citation: Hepatology. 1996 Jun;23(6):1448-55
references.pmid: 8675163
references.citation: Liver Transpl. 2007 Oct;13(10):1389-95
references.pmid: 17370334
references.citation: Infection. 1990 Jul-Aug;18(4):200-3
references.pmid: 2210850
references.citation: Nat Rev Gastroenterol Hepatol. 2009 Sep;6(9):542-53
references.pmid: 19652652
references.citation: Gastroenterology. 2006 Mar;130(3):687-94
references.pmid: 16530510
references.citation: J Hepatol. 2012 Aug;57(2):288-96
references.pmid: 22521347
references.citation: Drug Saf. 2013 Feb;36(2):135-44
references.pmid: 23325533
references.citation: N Engl J Med. 1993 Dec 16;329(25):1862-72
references.pmid: 8305063
references.citation: Lancet. 1993 Jul 31;342(8866):273-5
references.pmid: 8101303
references.citation: J Hepatol. 2012 Sep;57(3):675-88
references.pmid: 22609307
references.citation: Semin Liver Dis. 1986 May;6(2):97-106
references.pmid: 3529410
references.citation: Liver Transpl. 2007 Jun;13(6):822-8
references.pmid: 17539002
references.citation: Liver Transpl. 2007 Oct;13(10):1362-3
references.pmid: 17902141