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Canadian Journal of Gastroenterology - Volume 16 2002, Issue 10, Pages 672-676

Original Article Division of Hepatology, Hôpital Saint-Luc, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada

Received 17 May 2001; Accepted 8 August 2002

Copyright © 2002 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


BACKGROUND: Acute liver failure is a rare condition in which massive liver injury is associated with the rapid development of hepatic encephalopathy. Although viral hepatitis and drug-induced liver injury are the most common causes, no specific etiology is found in a substantial proportion of cases reported from Europe and the United States.

AIM: To determine the etiology and outcome of patients with acute liver failure in the authors’ institution.

PATIENTS AND METHODS: The charts of 81 consecutive patients admitted to Saint-Luc between 1991 and 1999 were reviewed.

RESULTS: The etiology was viral in 27 cases 33.2%, toxic or drug-induced in 22 27.2%, of unknown origin in 22 27.2% and due to various causes in 10 12.3% autoimmune, vascular, cancer. Of the 81 patients, 16% survived without liver transplantation, and 84% died or underwent liver transplantation. Survival without liver transplantation differed according to the mode of presentation: the survival rate was 27% in patients with hyperacute liver failure, 7% in those with acute liver failure and 0% in those with subacute liver failure. Among the 38 patients who underwent liver transplantation, survival one year after transplantation was 71%. In the 30 patients who died without liver transplantation, the main causes of death were cerebral edema and sepsis.

CONCLUSIONS: Acute liver failure is associated with a high mortality, and liver transplantation is the treatment of choice. In a significant proportion of cases, the etiology remains undetermined and is probably related to yet unidentified hepatotropic viruses.

Autor: Geneviève Tessier, Edith Villeneuve, and Jean-Pierre Villeneuve



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