@Article{Krasnodębski2016,
journal="Gastroenterology Review/Przegląd Gastroenterologiczny",
issn="1895-5770",
volume="11",
number="2",
year="2016",
title="Results of liver transplantation in patients with acute liver failure due to Amanita phalloides and paracetamol (acetaminophen) intoxication",
abstract=" Introduction:    Amanita phalloides  and paracetamol intoxications are responsible for the majority of acute liver failures.    Aim:  To assess survival outcomes and to analyse risk factors affecting survival in the studied group.    Material and methods : Of 1369 liver transplantations performed in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw before December 2013, 20 (1.46%) patients with  Amanita phalloides  (n = 13, 0.95%) and paracetamol (n = 7, 0.51%) intoxication were selected for this retrospective study. Overall and graft survival at 5 years were set as primary outcome measures.    Results : Five-year overall survival after liver transplantation in the studied group was 53.57% and 53.85% in patients with paracetamol and  Amanita phalloides  poisoning, respectively (p = 0.816). Five-year graft survival was 26.79% for patients with paracetamol and 38.46% with  Amanita phalloides  intoxication (p = 0.737). Risk factors affecting patient survival were: pre-transplant bilirubin concentration (p = 0.023) and higher number of red blood cells (p = 0.013) and fresh frozen plasma (p = 0.004) transfused intraoperatively. Likewise, higher number of red blood cells (p = 0.012) and fresh frozen plasma (p = 0.007) transfused were risk factors affecting 5-year graft survival. Surprisingly, donor and recipient blood type incompatibility was neither the risk factor for 5-year overall survival (p = 0.939) nor the risk factor for 5-year graft survival (p = 0.189).    Conclusions : In selected intoxicated patients urgent liver transplantation is the only successful modality of treatment. Risk factors affecting survival are in correspondence with the patient’s pre-transplant status (bilirubin level in serum) and intraoperative status (number of red blood cells and fresh frozen plasma transfused).",
author="Krasnodębski, Maciej
and Grąt, Michał
and Hołówko, Wacław
and Masior, Łukasz
and Wronka, Karolina M.
and Grąt, Karolina
and Stypułkowski, Jan
and Patkowski, Waldemar
and Krawczyk, Marek",
pages="90--95",
doi="10.5114/pg.2015.52031",
url="http://dx.doi.org/10.5114/pg.2015.52031"
}