Characterization and outcomes of young infants with acute liver failure

Shikha S. Sundaram; Estella M. Alonso; Michael R. Narkewicz; Song Zhang; Robert H. Squires

doi:10.1016/j.jpeds.2011.04.016

Characterization and outcomes of young infants with acute liver failure

Shikha S. Sundaram^*, Estella M. Alonso, Michael R. Narkewicz, Song Zhang, Robert H. Squires

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

110 Scopus citations

Abstract

Objective: To characterize infants aged ≤90 days enrolled in an international, multicenter, prospective registry of children aged <18 years with acute liver failure (ALF). Study design: The Pediatric Acute Liver Failure (PALF) Study Group collects prospective data on children from birth to 18 years. We analyzed data from infants aged ≤90 days enrolled in the PALF Study before May 18, 2009. Results: A total of 148 infants were identified in the PALF registry (median age, 18 days). Common etiologies of ALF were indeterminate (38%), neonatal hemochromatosis (13.6%), and herpes simplex virus (12.8%). Spontaneous survival occurred in 60% of the infants, 16% underwent liver transplantation, and 24% died without undergoing liver trsansplantation. Infants with indeterminate ALF were more likely to undergo liver transplantation than those with viral-induced ALF (P =.0002). The cumulative incidence of death without liver transplantation was higher in infants with viral ALF (64%) compared with those with neonatal hemochromatosis (16%) or indeterminate ALF (14%) (P = .0007). Conclusion: ALF in young infants presents unique diagnostic considerations. Spontaneous survival is better than previously thought. Liver transplantation provides an additional option for care.

Original language	English (US)
Pages (from-to)	813-818.e1
Journal	Journal of Pediatrics
Volume	159
Issue number	5
DOIs	https://doi.org/10.1016/j.jpeds.2011.04.016
State	Published - Nov 2011

Keywords

ALF
ALT
APAP
AST
Acetyl-para-aminophenol
Acute liver failure
Alanine aminotransferase
Aspartate aminotransferase
INR
International Normalized Ratio
NH
Neonatal hemochromatosis
PALF
PT
Pediatric Acute Liver Failure Study
Prothrombin time

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1016/j.jpeds.2011.04.016

Fingerprint Dive into the research topics of 'Characterization and outcomes of young infants with acute liver failure'. Together they form a unique fingerprint.

Cite this

@article{6c4cd56114c94153a889b5f7b3fcfb64,

title = "Characterization and outcomes of young infants with acute liver failure",

abstract = "Objective: To characterize infants aged ≤90 days enrolled in an international, multicenter, prospective registry of children aged <18 years with acute liver failure (ALF). Study design: The Pediatric Acute Liver Failure (PALF) Study Group collects prospective data on children from birth to 18 years. We analyzed data from infants aged ≤90 days enrolled in the PALF Study before May 18, 2009. Results: A total of 148 infants were identified in the PALF registry (median age, 18 days). Common etiologies of ALF were indeterminate (38%), neonatal hemochromatosis (13.6%), and herpes simplex virus (12.8%). Spontaneous survival occurred in 60% of the infants, 16% underwent liver transplantation, and 24% died without undergoing liver trsansplantation. Infants with indeterminate ALF were more likely to undergo liver transplantation than those with viral-induced ALF (P =.0002). The cumulative incidence of death without liver transplantation was higher in infants with viral ALF (64%) compared with those with neonatal hemochromatosis (16%) or indeterminate ALF (14%) (P = .0007). Conclusion: ALF in young infants presents unique diagnostic considerations. Spontaneous survival is better than previously thought. Liver transplantation provides an additional option for care.",

keywords = "ALF, ALT, APAP, AST, Acetyl-para-aminophenol, Acute liver failure, Alanine aminotransferase, Aspartate aminotransferase, INR, International Normalized Ratio, NH, Neonatal hemochromatosis, PALF, PT, Pediatric Acute Liver Failure Study, Prothrombin time",

author = "Sundaram, {Shikha S.} and Alonso, {Estella M.} and Narkewicz, {Michael R.} and Song Zhang and Squires, {Robert H.}",

note = "Funding Information: PALF Study Group member institutions are supported by the National Institutes of Health (Grants U01-DK 072146-04, ULI RR025014-01, UL1 RR024131, and UL1 RR024153 ) and General Clinical Research Centers (Grants M01 RR 08084 , to the University of Cincinnati, and MO1 RR00069 , to the University of Colorado). The authors declare no conflicts of interest. Funding Information: We thank the PALF Study Group for providing access to its clinical registry data. We are also grateful for support from the National Institutes of Health (Patricia R. Robuck, PhD, MPH, Director Clinical Trials Program, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases) and for assistance from members of the Data Coordinating Center at the University of Pittsburgh (directed by Steven Belle, PhD, MScHyg). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",

year = "2011",

month = nov,

doi = "10.1016/j.jpeds.2011.04.016",

language = "English (US)",

volume = "159",

pages = "813--818.e1",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

number = "5",

}

TY - JOUR

T1 - Characterization and outcomes of young infants with acute liver failure

AU - Sundaram, Shikha S.

AU - Alonso, Estella M.

AU - Narkewicz, Michael R.

AU - Zhang, Song

AU - Squires, Robert H.

N1 - Funding Information: PALF Study Group member institutions are supported by the National Institutes of Health (Grants U01-DK 072146-04, ULI RR025014-01, UL1 RR024131, and UL1 RR024153 ) and General Clinical Research Centers (Grants M01 RR 08084 , to the University of Cincinnati, and MO1 RR00069 , to the University of Colorado). The authors declare no conflicts of interest. Funding Information: We thank the PALF Study Group for providing access to its clinical registry data. We are also grateful for support from the National Institutes of Health (Patricia R. Robuck, PhD, MPH, Director Clinical Trials Program, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases) and for assistance from members of the Data Coordinating Center at the University of Pittsburgh (directed by Steven Belle, PhD, MScHyg). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.

PY - 2011/11

Y1 - 2011/11

N2 - Objective: To characterize infants aged ≤90 days enrolled in an international, multicenter, prospective registry of children aged <18 years with acute liver failure (ALF). Study design: The Pediatric Acute Liver Failure (PALF) Study Group collects prospective data on children from birth to 18 years. We analyzed data from infants aged ≤90 days enrolled in the PALF Study before May 18, 2009. Results: A total of 148 infants were identified in the PALF registry (median age, 18 days). Common etiologies of ALF were indeterminate (38%), neonatal hemochromatosis (13.6%), and herpes simplex virus (12.8%). Spontaneous survival occurred in 60% of the infants, 16% underwent liver transplantation, and 24% died without undergoing liver trsansplantation. Infants with indeterminate ALF were more likely to undergo liver transplantation than those with viral-induced ALF (P =.0002). The cumulative incidence of death without liver transplantation was higher in infants with viral ALF (64%) compared with those with neonatal hemochromatosis (16%) or indeterminate ALF (14%) (P = .0007). Conclusion: ALF in young infants presents unique diagnostic considerations. Spontaneous survival is better than previously thought. Liver transplantation provides an additional option for care.

AB - Objective: To characterize infants aged ≤90 days enrolled in an international, multicenter, prospective registry of children aged <18 years with acute liver failure (ALF). Study design: The Pediatric Acute Liver Failure (PALF) Study Group collects prospective data on children from birth to 18 years. We analyzed data from infants aged ≤90 days enrolled in the PALF Study before May 18, 2009. Results: A total of 148 infants were identified in the PALF registry (median age, 18 days). Common etiologies of ALF were indeterminate (38%), neonatal hemochromatosis (13.6%), and herpes simplex virus (12.8%). Spontaneous survival occurred in 60% of the infants, 16% underwent liver transplantation, and 24% died without undergoing liver trsansplantation. Infants with indeterminate ALF were more likely to undergo liver transplantation than those with viral-induced ALF (P =.0002). The cumulative incidence of death without liver transplantation was higher in infants with viral ALF (64%) compared with those with neonatal hemochromatosis (16%) or indeterminate ALF (14%) (P = .0007). Conclusion: ALF in young infants presents unique diagnostic considerations. Spontaneous survival is better than previously thought. Liver transplantation provides an additional option for care.

KW - ALF

KW - ALT

KW - APAP

KW - AST

KW - Acetyl-para-aminophenol

KW - Acute liver failure

KW - Alanine aminotransferase

KW - Aspartate aminotransferase

KW - INR

KW - International Normalized Ratio

KW - NH

KW - Neonatal hemochromatosis

KW - PALF

KW - PT

KW - Pediatric Acute Liver Failure Study

KW - Prothrombin time

UR - http://www.scopus.com/inward/record.url?scp=80054758141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054758141&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2011.04.016

DO - 10.1016/j.jpeds.2011.04.016

M3 - Article

C2 - 21621221

AN - SCOPUS:80054758141

VL - 159

SP - 813-818.e1

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 5

ER -

Characterization and outcomes of young infants with acute liver failure

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Cite this