Rabinowich L, Wendon J, Bernal W, Shibolet O. Clinical management of acute liver failure: Results of an international multi-center survey. World J Gastroenterol 2016; 22(33): 7595-7603 [PMID: 27672280 DOI: 10.3748/wjg.v22.i33.7595]
Corresponding Author of This Article
William Bernal, MD, FRCP, Liver Intensive Therapy Unit, Institute of Liver Studies, King’s College Hospital, Denmark Hill, London SE5 9RS, United Kingdom. william.bernal@kcl.ac.uk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
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Rabinowich L, Wendon J, Bernal W, Shibolet O. Clinical management of acute liver failure: Results of an international multi-center survey. World J Gastroenterol 2016; 22(33): 7595-7603 [PMID: 27672280 DOI: 10.3748/wjg.v22.i33.7595]
World J Gastroenterol. Sep 7, 2016; 22(33): 7595-7603 Published online Sep 7, 2016. doi: 10.3748/wjg.v22.i33.7595
Clinical management of acute liver failure: Results of an international multi-center survey
Oren Shibolet, William Bernal, Julia Wendon, Liane Rabinowich
Liane Rabinowich, Oren Shibolet, Liver Unit, Department of Gastroenterology, Tel-Aviv Medical Center and Tel-Aviv University, Tel-Aviv 64239, Israel
Julia Wendon, William Bernal, Liver Intensive Therapy Unit, Institute of Liver Studies, King’s College Hospital, London SE5 9RS, United Kingdom
Author contributions: Wendon J and Bernal W contributed to study concept and design and acquisition of data; Rabinowich L, Wendon J, Bernal W and Shibolet O contributed to analysis and interpretation of data; Rabinowich L contributed to statistical analysis; Rabinowich L and Shibolet O contributed to drafting of the manuscript; Wendon J, Bernal W and Shibolet O contributed to critical revision of the manuscript; Bernal W and Shibolet O contributed equally.
Institutional review board statement: Non-identifiable data was gathered as part of the EuroALF registry. The study was performed with the approval of the local research ethics committee.
Informed consent statement: Survey - the participants are EUROALF members listed in appendix A. Informed consent waiver was obtained.
Conflict-of-interest statement: The authors declare no conflict of interest related to this publication.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at william.bernal@kcl.ac.uk.
Correspondence to: William Bernal, MD, FRCP, Liver Intensive Therapy Unit, Institute of Liver Studies, King’s College Hospital, Denmark Hill, London SE5 9RS, United Kingdom. william.bernal@kcl.ac.uk
Telephone: +44-203-2994458 Fax: +44-203-2993167
Received: January 6, 2016 Peer-review started: January 6, 2016 First decision: January 28, 2016 Revised: March 3, 2016 Accepted: March 30, 2016 Article in press: March 30, 2016 Published online: September 7, 2016 Processing time: 242 Days and 0.2 Hours
Core Tip
Core tip: Acute liver failure is rare, but carries high mortality and resource use. Standard of care and clinical practice varies between centers. In a survey conducted among members of the European-Acute-Liver-Failure consortium we have identified similarities in principles of care, including basic clinical management, recognition of severity and care of critically ill patients. Major areas of divergence were pre-intensive care unit (ICU) care and elements of ICU care. Further research is required regarding intra-cranial pressure monitoring and therapy, prophylactic antibiotics and anti-fungals, and liver support systems; we also identified a great need for improving prognostic evaluation for liver transplantation and refinement of transplantation criteria.
