Acute liver failure in patients admitted to the intensive care unit—a Viennese retrospective single-center analysis

作者：Patrick Haselwanter, Seanna Fairfield, Marlene Riedl-Wewalka, Monika Schmid, Albert Friedrich Stättermayer, Thomas Reiberger, Michael Trauner, Christian Zauner, Mathias Schneeweiss‐Gleixner · 发表于：Wiener klinische Wochenschrift · 年份：2025 · DOI：10.1007/s00508-025-02539-1 · 被引用次数：5 · 研究领域：Liver Disease and Transplantation、Drug-Induced Hepatotoxicity and Protection、Hepatitis C virus research

BACKGROUND: Acute liver failure (ALF) is characterized by a rapid deterioration of liver function and a high mortality without transplantation depending on etiology and onset. Immediate transfer to a dedicated intensive care unit (ICU) and evaluation for high-urgency liver transplantation (HU-LTx) is recommended to maximize chances of survival. Data on ALF epidemiology are limited, particularly for Central Europe. METHODS: This retrospective single-center study included all ALF patients admitted to the ICU of the Department of Gastroenterology and Hepatology at the Vienna General Hospital between 2012 and 2024. RESULTS: Overall, 31 patients (median age of 44 [interquartile range, IQR 32-56] years, 20 [65%] female) were included. The primary causes of ALF were viral infections (n = 8; 26%), autoimmune hepatitis (n = 5; 16%), drug-induced liver injury (DILI; n = 3; 10%), and Wilson's disease (n = 4; 13%), while in 8 patients (26%) no cause was identified. Median length of ICU stay was 12 (IQR 4-21) days, with mean sequential organ failure assessment (SOFA) and simplified acute physiology score II (SAPS II) scores of 10.55 ± 4.56 and 40.97 ± 14.84. Overall ICU survival was 61% (n = 19). Non-HU-LTx patients (n = 18) had an ICU survival of 44%. HU-LTx was performed in 13 patients (42%), with 12 patients (92%) surviving 28 days. The 6‑month overall survival of HU-LTx patients was 85%. CONCLUSION: The diverse causes of ALF in Central Europe include most commonly viral infections, au...