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Akut leversvikt - viktigt med snabb multidisciplinär handläggning: [Acute liver failure--rapid multidisciplinary management]
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2007 (Swedish)In: Läkartidningen, ISSN 0023-7205, Vol. 104, no 4, 210-213 p.Article in journal (Other academic) Published
Abstract [en]

A recent study in Sweden on patients with acute liver failure (ALF) 1994-2003 demonstrated that the most common causes were paracetamol toxicity (42%) and idiosyncratic drug reactions (15%). In 11% of cases of ALF no definite etiology could be established. Among patients with paracetamol toxicity, the spontaneous survival without liver transplantation was 82% compared to 49% in patients with reactions to other drugs and 29% among the patients with indeterminate cause. Patients with ALF need a rapid and effective diagnostic work-up to detect the etiology as this often determines the outcome. In ALF it is of major importance to make an early contact with a transplant centre as the search for a suitable donor organ may take time in patients who are candidates for a liver transplantation. Patients with acute liver failure need a multidisciplinary care with co-operation between hepatologists, intensive care unit specialists and transplant surgeons.

Abstract [sv]

En sammanställning av etiologin till akut leversvikt hos patienter i Sverige 1994–2003 visade att paracetamolförgiftningar (42 procent) och idiosynkratisk, läkemedelsinducerad leverskada (15 procent) var de vanligaste orsakerna.

Prognosen varierade stort beroende på etiologin.

Sammanlagt 13 procent av patienterna med paracetamolförgiftning avled, och 5 procent transplanterades. Av patienterna med akut leversvikt orsakad av idiosynkratisk, läkemedelsinducerad leverskada transplanterades 49 procent.

Det är viktigt med snabb utredning av patienter med akut leversvikt, eftersom prognosen avgörs av etiologin. Det är även av betydelse att ta kontakt med ett transplantationscentrum tidigt.

Patienter med svår leversvikt kräver ett multidisciplinärt omhändertagande med samarbete mellan hepatologer, intensivvårdsläkare och transplantationskirurger.

Place, publisher, year, edition, pages
2007. Vol. 104, no 4, 210-213 p.
Keyword [en]
Acetaminophen/poisoning, Adult, Analgesics; Non-Narcotic/poisoning, Hepatitis/complications, Humans, Liver Failure; Acute/diagnosis/etiology/therapy, Liver Transplantation, Middle Aged, Patient Care Planning, Pharmaceutical Preparations/adverse effects, Prognosis
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-11469PubMedID: 17328461OAI: oai:DiVA.org:uu-11469DiVA: diva2:39238
Available from: 2007-09-17 Created: 2007-09-17 Last updated: 2010-05-28Bibliographically approved

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Lööf, Lars
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Department of Medical SciencesCentre for Clinical Research, County of Västmanland
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