Etiology and Outcome of Adult and Pediatric Acute Liver Failure in Europe

Author:

Lenz Dominic12,Hørby Jørgensen Marianne23,Kelly Deirdre24,Cardinale Vincenzo25,Geerts Anja26,Gonçalves Costa Isabel27,Fichtner Alexander12,Garbade Sven F.12,Hegen Bianca28,Hilberath Johannes29,de Kleine Ruben210,Kupčinskas Limas211,McLin Valérie212,Niesert Moritz12,Prado Gonzalez Veronica213,Sturm Ekkehard29,Staufner Christian12,Tjwa Eric214,Willemse José215,Zecher Britta F.216,Larsen Fin Stolze217,Sebode Marcial216,Ytting Henriette21819

Affiliation:

1. Department of Pediatrics I, Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany

2. European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany

3. Department of Pediatrics and Adolescent Medicine, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark

4. Liver Unit, Birmingham Women’s and Children’s Hospital, University of Birmingham, Birmingham, United Kingdom

5. Medical-Surgical and Biotechnologies Sciences, Polo Pontino, Sapienza University of Rome, Latina, Italy

6. Hepatology Research Unit, Department of Internal Medicine and Paediatrics, Liver Research Center Ghent, Ghent University, Ghent, Belgium

7. Unidade de Hepatologia e Transplantação Hepática Pediátrica, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

8. University Children’s Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

9. Paediatric Gastroenterology/Hepatology, University Hospital Tuebingen, Tuebingen, Germany

10. Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands

11. Institute for Digestive Research and Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania

12. Swiss Pediatric Liver Center, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals Geneva and University of Geneva, Geneva, Switzerland

13. Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

14. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands

15. Dutch Liver Patient Association (NLV), Hoogland, The Netherlands

16. I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

17. Department of Gastroenterology and Hepatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

18. Gastro Unit, Medical Division, Hvidovre University Hospital, Copenhagen, Denmark

19. Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

Abstract

Acute liver failure (ALF) is rare but life-threatening. Common causes include intoxications, infections, and metabolic disorders. Indeterminate etiology is still frequent. No systematic data on incidence, causes, and outcome of ALF across Europe are available. Via an online survey we reached out to European Reference Network Centers on rare liver diseases. Numbers and etiology of ALF cases during 2020 were retrieved and diagnostic and treatment availabilities assessed. In total, 455 cases (306 adult, 149 pediatric) were reported from 36 centers from 20 countries. Intoxication was the most common cause in adult and pediatric care. The number of cases with indeterminate etiology is low. Diagnostic tools and specific treatment options are broadly available within this network. This is the first approach to report on etiology and outcome of ALF in the pediatric and adult population in Europe. High diagnostic yield and standard of care reflects the expert status of involved centers.

Publisher

Wiley

Subject

Gastroenterology,Pediatrics, Perinatology and Child Health

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