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5 - Acute Liver Failure in Children

from SECTION I - PATHOPHYSIOLOGY OF PEDIATRIC LIVER DISEASE

Published online by Cambridge University Press:  18 December 2009

By
Estella M. Alonso M.D. ,
Robert H. Squires M.D.  and
Peter F. Whitington M.D.
Edited by
Frederick J. Suchy ,
Ronald J. Sokol  and
William F. Balistreri
Estella M. Alonso M.D.
Affiliation:
Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Director of Hepatology, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois
Robert H. Squires M.D.
Affiliation:
Professor of Pediatrics, Divison of Pediatric Gastroenterology and Hepatology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
Peter F. Whitington M.D.
Affiliation:
Sally Burnett Searle Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Division Head, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois
Frederick J. Suchy
Affiliation:
Mount Sinai School of Medicine, New York
Ronald J. Sokol
Affiliation:
University of Colorado, Denver
William F. Balistreri
Affiliation:
University of Cincinnati
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Summary

Acute liver failure (ALF) is a relatively rare but often fatal event in children. The frequency of ALF in all age groups in the United States is about 10 to 20,000 per year (about 17 cases per 100,000 population per year), but the frequency in the pediatric age group is unknown. ALF accounts for 10–15% of pediatric liver transplants performed in the United States annually. Even allowing for the probability that many children die without transplant, there may be as few as 50–100 cases per year in the United States.

Little is known about pediatric ALF; the rarity of the condition has precluded accumulation of a large experience. Several studies are under way to amass the experience of major transplant centers in an effort to learn more about the condition. Most cases of ALF in children have no identifiable cause, which has prevented a focus on the mechanism by which hepatocytes are killed. The mechanism of ALF remains elusive even if the cause is known. Orthotopic liver transplantation is a substantial advance in the therapy of ALF. Other therapies being studied in clinical trials include liver assist devices and hepatocyte transplantation. Medical therapy generally consists of supportive measures, with a focus on preventing or treating complications and early referral to a transplant center. Outcomes for children vary depending upon the etiology and degree of central nervous system (CNS) involvement.

Type
Chapter
Information
Liver Disease in Children , pp. 71 - 96
Publisher: Cambridge University Press
Print publication year: 2007

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  • Acute Liver Failure in Children
    • By Estella M. Alonso, M.D., Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Director of Hepatology, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois, Robert H. Squires, M.D., Professor of Pediatrics, Divison of Pediatric Gastroenterology and Hepatology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, Peter F. Whitington, M.D., Sally Burnett Searle Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Division Head, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois
  • Edited by Frederick J. Suchy, Mount Sinai School of Medicine, New York, Ronald J. Sokol, University of Colorado, Denver, William F. Balistreri, University of Cincinnati
  • Book: Liver Disease in Children
  • Online publication: 18 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547409.007
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  • Acute Liver Failure in Children
    • By Estella M. Alonso, M.D., Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Director of Hepatology, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois, Robert H. Squires, M.D., Professor of Pediatrics, Divison of Pediatric Gastroenterology and Hepatology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, Peter F. Whitington, M.D., Sally Burnett Searle Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Division Head, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois
  • Edited by Frederick J. Suchy, Mount Sinai School of Medicine, New York, Ronald J. Sokol, University of Colorado, Denver, William F. Balistreri, University of Cincinnati
  • Book: Liver Disease in Children
  • Online publication: 18 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547409.007
Available formats
×

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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Acute Liver Failure in Children
    • By Estella M. Alonso, M.D., Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Director of Hepatology, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois, Robert H. Squires, M.D., Professor of Pediatrics, Divison of Pediatric Gastroenterology and Hepatology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, Peter F. Whitington, M.D., Sally Burnett Searle Professor, Department of Pediatrics, Northwestern University, Chicago, Illinois; Division Head, Department of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Hospital, Chicago, Illinois
  • Edited by Frederick J. Suchy, Mount Sinai School of Medicine, New York, Ronald J. Sokol, University of Colorado, Denver, William F. Balistreri, University of Cincinnati
  • Book: Liver Disease in Children
  • Online publication: 18 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547409.007
Available formats
×