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 Giuliano 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.

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].

The enterohepatic circulation of amanitin: kinetics and therapeutical implications.

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.



Liver transplantation for severe Amanita phalloides mushroom poisoning.

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.

Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning

  • P. FaybikH. Hetz 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].