Liver transplantation represents the optimal treatment for fulminant hepatic failure from amanita phalloides poisoning

  title={Liver transplantation represents the optimal treatment for fulminant hepatic failure from amanita phalloides poisoning},
  author={Fabrizio Panaro and Enzo Andorno and Nicola Morelli and Marco Casaccia and G Bottino and Ferruccio Ravazzoni and Monica Centanaro and Sara Ornis and Umberto Valente},
  journal={Transplant International},
Amanita phalloides (AP) mushrooms poisoning is a rare but serious occurrence. The main causes of this intoxication are the amatoxines, which inhibit DNA-dependent RNA polymerase II or B. The typical liver and kidney alterations of AP poisoning, consisting of massive hepatic central lobular cell necrosis and acute tubular necrosis of the kidney, are well known [1]. Recognizing the phalloides syndrome allows the institution of effective treatment to avoid possibly fatal complications. The overall… 
Amanita poisoning and liver transplantation: do we have the right decision criteria?
A 17-month-old boy with A phalloides intoxication and ALF rapidly developed hepatic encephalopathy stage II-III with somnolence, irritability, and inconsolable crying episodes and spontaneously recovered in the hours before emergent living donor liver transplantation.
Successful outcome of severe Amanita phalloides poisoning in children
Children with FHF due to A. phalloides intoxication should be considered early for emergency LTx but should be monitored closely for the necessity of definite LTx, and early detoxification with active charcoal as well as silibinin and NAC seems to improve the outcome.
Challenges in the early diagnosis of patients with acute liver failure induced by amatoxin poisoning
It is suggested that patients with unidentified wild mushroom intoxication with delayed gastroenteritis could be clinically diagnosed with amatoxin poisoning; in such cases, liver coagulation function should be frequently evaluated.
Urgent liver transplantation for Amanita phalloides poisoning
Amanita phalloides is a deadly wild mushroom causing severe damage in man ranging from diarrhea to organ dysfunction, and treatment includes supportive measures, inactivation of the toxin and if liver failure occurs liver transplantation.
Hepatotoxicity from ingestion of wild mushrooms of the genus Amanita section Phalloideae collected in Mexico City: two case reports.
These cases demonstrate that the consumption of wild mushrooms without proper knowledge of toxic species represents a serious and under recognized health problem.
Pilzvergiftungen: Toxidrome, Diagnose und Therapie
  • P. Kaufmann
  • Medicine
    Wiener Medizinische Wochenschrift
  • 2007
Late syndromes (symptom onset > 6 hrs after ingestion) are life-threatening due to liver- and renal failure, and patients who are jaundiced after an acute gastrointestinal episode, are suspected to be poisoned with Amatoxins.
[Mushroom poisoning by brunneoincarnata: about two cases].
A collective intoxication by Lepiota brunneoincarnata is reported, most of them involved other species which can often be linked to edible mushroom, with the knowledge of mushroom.
The enterohepatic circulation of amanitin: kinetics and therapeutical implications.
Amanitin disappeared almost completely from systemic and enterohepatic circulation within 24 h, suggesting that systemic detoxification and/or interrupting the entero hemostatic circulation at a later date might be poorly effective.
Application of the Liver Maximum Function Capacity Test in Acute Liver Failure: A Helpful Tool for Decision-Making in Liver Transplantation?
Application of a noninvasive liver function test might help to determine the prognosis of ALF and support decision-making for or against LTx as well as acceptance of a critical donor organ in case of a critically ill patient.
Assessment of α-amanitin toxicity and effects of silibinin and penicillin in different in vitro models.
It is shown that SilBS has significant advantage over SilEtOH with no additional benefit of penicillin and HepG2 cells may not represent an appropriate model to investigate Amanita phalloides poisoning in vitro with focus on OATP transporters since these cells are lacking sensitivity towards α-amanitin.


Liver transplantation for severe Amanita phalloides mushroom poisoning.
This largest experience with liver transplantation for Amanita poisoning further defines the early clinical and laboratory indications for, and the unique complicating features of, transplantation in this setting.
MARS: optimistic therapy method in fulminant hepatic failure secondary to cytotoxic mushroom poisoning--a case report.
The treatments increase the rate of toxin elimination to the extent that the toxic exposure of highly susceptible cells, such as hepatocytes, is minimized, which leads to the surprise recovery of the poisoning patient, despite her severe condition, even as late as up to a week after mushroom ingestion.
Histological criteria for diagnosis of amanita phalloides poisoning.
Although poisoning by Amanita phalloides is rare, these cases confirm the requirement for as complete a comparison as possible between circumstantial histopathological and toxicological data for the purposes of forensic diagnosis.
Early indicators of prognosis in fulminant hepatic failure.
The successful use of orthotopic liver transplantation in fulminant hepatic failure has created a need for early prognostic indicators to select the patients most likely to benefit at a time when
Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning
  • P. Faybik, H. Hetz, +5 authors H. Steltzer
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2003
The relative late onset of symptoms is a distinct diagnostic feature of Amanita intoxication and also the main reason of failure for extracorporeal removal of Amanitas‐specific toxins from the gut and circulation.
[Acute liver failure].