King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever.
| Title: | King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever. |
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| Authors: | Athanasio BDS; Department of Surgery, Federal University of Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil.; Andrade AMF; Liver Transplantation Unit, Felicio Rocho Hospital, Belo Horizonte 30110-934, Minas Gerais, Brazil.; Costa VV; Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil.; Castro JF; Liver Transplantation Unit, Felicio Rocho Hospital, Belo Horizonte 30110-934, Minas Gerais, Brazil.; Garcia SLM; Liver Transplantation Unit, Felicio Rocho Hospital, Belo Horizonte 30110-934, Minas Gerais, Brazil.; Teixeira MM; Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil.; Souza DDG; Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil.; Vidigal PVT; Department of Pathology, Federal University of Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil.; Lima CX; Department of Surgery, Federal University of Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil. cxlima@ufmg.br. |
| Source: | World journal of transplantation [World J Transplant] 2025 Mar 18; Vol. 15 (1), pp. 100413. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101608356 Publication Model: Print Cited Medium: Print ISSN: 2220-3230 (Print) Linking ISSN: 22203230 NLM ISO Abbreviation: World J Transplant Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group; Original Publication: Hong Kong : Baishideng Pub. Group Co., Ltd. |
| Abstract: | Background: Acute liver failure (ALF) is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease. Liver transplantation (LT) is the most impactful treatment. Yellow fever (YF) is an infectious disease that primarily affects the liver and has a high mortality rate. However, LT can be a viable option for treating rare cases with extensive liver involvement. However, the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.; Aim: To present necessary adjustments to established scoring systems for ALF secondary to YF.; Methods: This was an observational, retrospective, single-center study. Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil. During hospitalization, general supportive therapeutic measures were implemented, and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure. LT is considered a viable measure for patients with signs of end-stage liver failure.; Results: Eight of 14 (57%) patients developed severe neurological alterations within the first 96 hours after hospital admission. Four patients underwent emergency LT, and despite a moderate viral infection of the graft after transplantation, the 5-year survival rate was 50%. Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF, they are insufficient for predicting the risk of mortality in this context, primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.; Conclusion: To ensure good applicability in cases of YF-induced ALF, the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.; (©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.) |
| Competing Interests: | Conflict-of-interest statement: All the authors report no conflicts of interest for this article. |
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| Contributed Indexing: | Keywords: Acute liver failure; Clichy–Villejuif criteria; King's College criteria; Liver transplantation; Yellow fever |
| Entry Date(s): | Date Created: 20250319 Latest Revision: 20250320 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11612883 |
| DOI: | 10.5500/wjt.v15.i1.100413 |
| PMID: | 40104189 |
| Database: | MEDLINE |
Journal Article