Indeterminate etiology of acute liver failure in North America: Less common, still grave prognosis

• DOI: 10.1111/ctr.15128
• Publication Date: 2023-09-14T13:18:53Z
• Authors: Parita V. Patel; Sherry Livingston; Jorge L. Rakela; R. Todd Stravitz; Adrian Reuben; Nathan M. Bass; Shannan R. Tujios; Anne M. Larson; Norman L. Sussman; Jody A. Rule; Valerie L. Durkal...; William M. Lee; Daniel R. Ganger
• Keywords: Etiology

Abstract Background The etiology of acute liver failure (ALF) remains one the most important factors in determining prognosis and predicting outcomes. In a significant proportion ALF cases, however, unknown is categorized as indeterminate (IND‐ALF). this study, we summarize findings from patients with IND‐ALF 32 transplant centers across United States, compare laboratory, prognostic, outcome data for IND‐ALF. Methods Between 1998 2019, 3364 adult or injury (ALI) were enrolled ALFSG registry. primary clinical interest was 21‐day transplant‐free survival (TFS). Results Of registry, 3.4 % ( n = 114) adjudicated true indeterminate. On multivariate analysis, lower bilirubin, INR, lack use mechanical ventilation no features coma at baseline had higher odds ratio free survival. number deaths similar between true‐IND versus indeterminable (29.8% vs. 27.2%), almost half requiring (42.1% 45.7%). Conclusion We illustrate poor prognoses that true‐IND‐ALF carry need emergency transplantation cases.