Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19807
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dc.contributor.authorPorteous, Jennifer-
dc.contributor.authorCioccari, Luca-
dc.contributor.authorAncona, Paolo-
dc.contributor.authorOsawa, Eduardo A-
dc.contributor.authorJones, Kelly-
dc.contributor.authorGow, Paul J-
dc.contributor.authorAngus, Peter W-
dc.contributor.authorWarrillow, Stephen J-
dc.contributor.authorBellomo, Rinaldo-
dc.date2018-10-31-
dc.date.accessioned2018-11-26T00:51:07Z-
dc.date.available2018-11-26T00:51:07Z-
dc.date.issued2018-10-31-
dc.identifier.citationLiver Transplantation : Official Publication of the American Association For the Study of Liver Diseases and the International Liver Transplantation Society 2018; online first: 31 Octoberen_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/19807-
dc.description.abstractAcetaminophen-induced acute liver failure (ALF) may require emergency liver transplantation (LT) in the presence of specific criteria, and its management may also include intracranial pressure (ICP) monitoring in selected patients at high risk of cerebral edema. We aimed to test the hypothesis that management of such patients without ICP monitoring or LT would yield outcomes similar to those reported with conventional management. We interrogated a database of all patients treated in ICU for acetaminophen-induced ALF between November 2010 and October 2016 and obtained relevant information from electronic medical records. We studied 64 patients (58 females) with a median age of 38 years. Such patients had a high prevalence of depression, substance abuse or other psychiatric disorders and had ingested a median acetaminophen dose of 25g. No patient received ICP monitoring or LT. Overall, 51 (79.7%) patients survived. Of the 42 patients who met King's College Hospital (KCH) criteria, 29 (69.1%) survived without transplantation. Forty-five patients developed severe hepatic encephalopathy, and 32 (71.1%) of these survived. Finally, compared to KCH criteria, the current UK registration criteria (UKRC) for super-urgent LT had better sensitivity (92.3%) and specificity (80.4%) for hospital mortality. In a center applying a no ICP monitoring and no LT approach to the management of acetaminophen-induced ALF, over six years, overall survival was 79.7% and for patients fulfilling KCH criteria 69.1%, both higher than for equivalent patients treated with conventional management as reported in the literature. Finally, the current UKRC may be a better predictor of hospital mortality in this patient population. This article is protected by copyright. All rights reserved.en_US
dc.language.isoeng-
dc.subjectAcetaminophenen_US
dc.subjectacute liver failureen_US
dc.subjectdrug overdoseen_US
dc.subjecthepatotoxicityen_US
dc.subjectliver transplantationen_US
dc.titleThe Outcome of Acetaminophen-Induced Acute Liver Failure managed without Intracranial Pressure Monitoring or Transplantation.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleLiver Transplantation : Official Publication of the American Association For the Study of Liver Diseases and the International Liver Transplantation Societyen_US
dc.identifier.affiliationVictorian Liver Transplant Uniten_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationDepartment of Intensive Care Medicine, University Hospital University of Bern, Switzerlanden_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine Monash University, Prahran, Victoria, Australiaen_US
dc.identifier.doi10.1002/lt.25377en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-1650-8939en_US
dc.identifier.orcid0000-0002-7240-4106en_US
dc.identifier.pubmedid30379388-
dc.type.austinJournal Article-
local.name.researcherAngus, Peter W
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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