Aetiology and outcome of acute hepatic failure in Greece: experience of two academic hospital centres
Article first published online: 19 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 28, Issue 6, pages 821–827, July 2008
How to Cite
Koskinas, J., Deutsch, M., Kountouras, D., Kostopanagiotou, G., Arkadopoulos, N., Smyrniotis, V., Rapti, I., Manesis, E. and Archimandritis, A. (2008), Aetiology and outcome of acute hepatic failure in Greece: experience of two academic hospital centres. Liver International, 28: 821–827. doi: 10.1111/j.1478-3231.2008.01782.x
- Issue published online: 4 JUN 2008
- Article first published online: 19 MAY 2008
- Received 18 July 2007Accepted 2 April 2008
- acute liver failure;
Introduction: In Western countries, the most frequent aetiology of acute liver failure (ALF) is acetaminophen overdose, while in developing countries viral infections [hepatitis A virus and hepatitis B virus (HBV)] predominate.
Aim: To evaluate the epidemiology, clinical characteristics, outcome and prognostic factors of survival of patients with ALF in Greece during the last 6 years.
Results: A total of 40 patients, 28 females (70%), with a median age of 37.4±18.6 years (range: 15–84) with ALF were studied. HBV infection was the cause in 53% of them (compared with 74% from a previous study reported in the early 1980s), drug toxicity in 15% and undetermined in 13%. The overall survival was 57.5%, including 94% with and 15% without liver transplantation. Forty-five per cent of our patients had emergency liver transplantation in European Centers within a median time of 3.3 days (1–9) from admission. The total bilirubin level at admission and the development of infections were found to be significantly associated with poor outcome.
Conclusions: Hepatitis B virus still remains the most important cause of ALF in Greece, but shows a significant decrease as compared with studies in the early 1980s. Almost half of our patients needed emergency liver transplantation and had a very good survival rate. The other 15% of the patients presented spontaneous survival only with intensive medical support.