Successful treatment of a child with fulminant liver failure and coma caused by Amanita phalloides intoxication with albumin dialysis without liver transplantation

@article{Rubik2004SuccessfulTO,
  title={Successful treatment of a child with fulminant liver failure and coma caused by Amanita phalloides intoxication with albumin dialysis without liver transplantation},
  author={Jacek Rubik and Elzbieta Pietraszek-Jezierska and Andrzej Kamiński and Anna Skarżyńska and Sergiusz J{\'o}źwiak and Joanna Pawłowska and Tomasz Drewniak and Sylwester Prokurat and Ryszard Grenda and Piotr Kaliciński},
  journal={Pediatric Transplantation},
  year={2004},
  volume={8}
}
Abstract:  FLF is a life‐threatening disease. Hepatic coma exerts dramatic impact on patient survival. At present, LTx is the treatment modality of choice that provides significant improvement in outcome of most patients with FLF. Multiple attempts have been made to reduce mortality and improve the patient's condition. One of the new options is AD – MARS. We present the case of a 11‐yr‐old boy with FLF and hepatic coma who avoided the scheduled LTx because of rapid neurological and biochemical… 
Successful treatment of a child with fulminant liver failure and coma due to Amanita phalloides poisoning using urgent liver transplantation.
TLDR
The case of an 11-year-old boy with fulminant liver failure and hepatic coma due to Amanita phalloides poisoning treated with an urgent pediatric orthotopic liver transplantation is presented.
Fulminant liver failure secondary to mushroom poisoning in children: Importance of early referral to a liver transplantation unit
Abstract:  Patients poisoned with toxic mushrooms have a spectrum of clinical presentations ranging from gastrointestinal symptoms to fulminant liver failure, and outcomes range from complete
Successful treatment of an adult with Amanita phalloides-induced fulminant liver failure with molecular adsorbent recirculating system (MARS).
TLDR
MARS appears to be a safe and highly effective depurative therapy in adults with Amanita phalloides-induced FLF.
Is MARS system enough for A.phalloides-induced liver failure treatment?
TLDR
MARS is an effective depurative therapy in adults with A.phalloides-induced LF, but alone is not enough, and survival is predicted by the results of the initial MARS, amount of mushroom consumed, and time from toxin exposure.
Successful outcome of severe Amanita phalloides poisoning in children
TLDR
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.
Mushroom Poisoning: A Clinical Model of Toxin-Induced Centrilobular Necrosis
TLDR
There is no clear evidence that any pharmacological agent or any extracorporeal detoxification system can help to prevent the extent of liver cell necrosis in Amanita mushroom poisoning.
Urgent liver transplantation for Amanita phalloides poisoning
TLDR
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.
Experience of Treatments of Amanita phalloides–Induced Fulminant Liver Failure with Molecular Adsorbent Recirculating System and Therapeutic Plasma Exchange
TLDR
Both TPE and MARS might remove toxins and improve liver functions but a single session of TPE produced immediately greater improvements in alanine aminotransferase than MARS, suggesting early intervention may be more effective than delayed therapy.
Long‐lasting extracorporeal albumin dialysis in a child with end‐stage renal disease and severe cholestasis
TLDR
Long‐lasting MARS dialysis is feasible in children, decreases adverse effects of severe chronic cholestasis, and may help to preserve nutritional status prior to combined liver–kidney transplantation.
Pilzvergiftungen: Toxidrome, Diagnose und Therapie
  • P. Kaufmann
  • Medicine
    Wiener Medizinische Wochenschrift
  • 2007
TLDR
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.
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References

SHOWING 1-10 OF 20 REFERENCES
Fulminant hepatic failure: pediatric aspects.
TLDR
Urgent transplantation should be considered when the maximum International Normalized Ratio (INR) reached during the course of the illness is the most sensitive predictor of outcome, mortality being 86% with an INR > or = 4, and 27% with a INR < 4 in the authors' own series.
[Fulminant hepatitis in children].
TLDR
The management of children with fulminant hepatic failure has been significantly transformed by emergency orthotopic liver transplantation, but still encounters serious problems including patient selection, organ availability, and the definition of optimum preoperative management of these patients.
Extracorporeal Treatment in Fulminant Hepatic Failure: Pathophysiologic Considerations
TLDR
The pathophysiology of hepatic encephalopathy and cerebral edema is integrated into a proposed future concept of liver support for patients on the waiting list for liver transplantation.
Liver Transplantation in Mushroom Poisoning
TLDR
A case of FHF related to mushroom poisoning that required liver transplantation is presented and it appears that the severity of coagulopathy and encephalopathy predicts a poor outcome, whereas the degree of bilirubin elevation may not.
Outcome of children with cerebral edema caused by fulminant hepatic failure.
TLDR
Orthotopic liver transplantation should be performed in children with severe and worsening encephalopathy before the development of radiographically apparent cerebral edema, as this study found that survival was correlated with a lesser degree of coma.
Clinical management of acute hepatic failure
TLDR
A critical appraisal of specific clinical areas, including the management of cardiovascular, cerebral, renal, coagulopathic and infective complications are presented, as well as emerging therapies including non-biological and hybrid liver support systems that may provide a "bridge to transplantation".
Plasmapheresis in the treatment of Amanita phalloides poisoning: II. A review and recommendations.
  • S. Jander, J. Bischoff, B. Woodcock
  • Medicine
    Therapeutic apheresis : official journal of the International Society for Apheresis and the Japanese Society for Apheresis
  • 2000
TLDR
This review of 14 investigations published over the last 20 years shows that the introduction of detoxification techniques, in particular the use of plasmapheresis, in combination with supportive therapy to prevent the absorption of aminitine toxins into blood, produced a substantial reduction in mortality.
MARS: optimistic therapy method in fulminant hepatic failure secondary to cytotoxic mushroom poisoning--a case report.
TLDR
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.
Diagnosis and treatment of hepatic encephalopathy.
  • A. Blei
  • Medicine
    Bailliere's best practice & research. Clinical gastroenterology
  • 2000
TLDR
The treatment of hepatic encephalopathy has three aims: decrease the nitrogenous load from the gut, improve the extra-intestinal elimination of ammonia and counteract central abnormalities of neurotransmission.
Liver transplantation for fulminant hepatic failure in the pediatric patient.
TLDR
Overall results are comparable to those achieved for less emergent non-neoplastic indications in this same age group and ventilator dependency prior to transplantation is the strongest predictor of ultimate survival, followed by recipient age.
...
1
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