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Multicenter Study
. 2011 Nov;159(5):813-818.e1.
doi: 10.1016/j.jpeds.2011.04.016. Epub 2011 May 31.

Characterization and outcomes of young infants with acute liver failure

Shikha S Sundaram  1 , Estella M Alonso, Michael R Narkewicz, Song Zhang, Robert H Squires; Pediatric Acute Liver Failure Study Group
Collaborators, Affiliations
Multicenter Study

Characterization and outcomes of young infants with acute liver failure

Shikha S Sundaram et al. J Pediatr. 2011 Nov.

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The cumulative incidence of transplantation by etiology in infants 0-90 days of age in the PALF Study.
Figure 2
Figure 2
The cumulative incidence of death without transplantation by etiology in infants 0-90 days of age in the PALF Study.
See this image and copyright information in PMC

References

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