{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:23:47Z","timestamp":1788020627877,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2009,10,1]],"date-time":"2009-10-01T00:00:00Z","timestamp":1254355200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2009,9,29]],"date-time":"2009-09-29T00:00:00Z","timestamp":1254182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Paracetamol (acetaminophen) hepatotoxicity, whether due to intentional overdose or therapeutic misadventure, is an indication for liver transplantation in selected cases. However, there is a concern that long-term outcomes may be compromised by associated psychopathology that may predispose patients to further episodes of self-harm or poor treatment adherence. We therefore undertook a retrospective analysis of patients transplanted for paracetamol-induced fulminant hepatic failure (FHF) to determine their long-term outcomes, psychiatric problems, and compliance and whether these issues could be predicted from pretransplant information. Records from patients undergoing liver transplantation for paracetamol-associated liver failure in this unit and 2 comparison groups (patients undergoing liver replacement for FHF from other causes and for chronic liver diseases) were examined. Of 60 patients transplanted for paracetamol-induced FHF between 1989 and 2007, 44 (73%) survived to discharge. Currently, 35 patients (58%) are surviving at an average of 9 years post-transplantation. The incidence of psychiatric disease (principally depression) and 30-day mortality were greatest in the paracetamol group, but for those who survived 30 days, there was no difference in long-term survival rates between the groups. Adherence to follow-up appointments and compliance with immunosuppression were lowest in the paracetamol overdose group. Poor adherence was not predicted by any identifiable premorbid psychiatric conditions. Two patients grafted for paracetamol FHF died from self-harm (1 from suicide and 1 from alcoholic liver disease after 5 years). This study suggests that, notwithstanding the shortage of donor liver grafts, transplantation is an appropriate therapy in selected patients, although close follow-up is indicated. Liver Transpl 15:1351\u20131357, 2009. \u00a9 2009 AASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lt.21799","type":"journal-article","created":{"date-parts":[[2009,9,29]],"date-time":"2009-09-29T09:54:22Z","timestamp":1254218062000},"page":"1351-1357","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":37,"title":["Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure"],"prefix":"10.1097","volume":"15","author":[{"given":"Sheldon C.","family":"Cooper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland C.","family":"Aldridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahir","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Webb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nightingale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Paris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget K.","family":"Gunson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Mutimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Neuberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-29-20250326","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1136\/jech.51.2.175","article-title":"Use of paracetamol for suicide and nonfatal poisoning in the UK and France: are restrictions on availability justified?","volume":"51","author":"Gunnell","year":"1997","journal-title":"J Epidemiol Community Health"},{"key":"R2-29-20250326","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1046\/j.1365-2710.2003.00497.x","article-title":"Paracetamol poisoningimpact of pack size restrictions.","volume":"28","author":"Hughes","year":"2003","journal-title":"J Clin Pharm Ther"},{"key":"R3-29-20250326","doi-asserted-by":"crossref","first-page":"465","DOI":"10.2165\/00002018-200730060-00002","article-title":"Impact of restricting paracetamol pack sizes on paracetamol poisoning in the United Kingdom: a review of the literature.","volume":"30","author":"Hawkins","year":"2007","journal-title":"Drug Saf"},{"key":"R4-29-20250326","first-page":"CD003328","article-title":"Interventions for paracetamol (paracetamol) overdose.","volume":"19","author":"Brok","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"R5-29-20250326","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/lt.500050107","article-title":"Cause and prognosis in acute liver failure.","volume":"5","author":"Riordan","year":"2003","journal-title":"Liver Transpl"},{"key":"R6-29-20250326","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/0016-5085(89)90081-4","article-title":"Early indicators of prognosis in fulminant hepatic failure.","volume":"97","author":"OGrady","year":"1989","journal-title":"Gastroenterology"},{"key":"R7-29-20250326","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/00003246-199802000-00026","article-title":"Earlier identification of patients at risk from acetaminopheninduced acute liver failure.","volume":"26","author":"Mitchell","year":"1998","journal-title":"Crit Care Med"},{"key":"R8-29-20250326","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1192\/bjp.152.3.359","article-title":"Suicide and other causes of death following attempted suicide.","volume":"152","author":"Hawton","year":"1988","journal-title":"Br J Psychiatry"},{"key":"R9-29-20250326","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1192\/bjp.172.3.239","article-title":"Thirteen year followup of deliberate self harm, using linked data.","volume":"172","author":"Hall","year":"1998","journal-title":"Br J Psychiatry"},{"key":"R10-29-20250326","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1136\/bmj.306.6893.1637","article-title":"High mortality by natural and unnatural causes: a 10 year followup study of patients admitted to a poisoning treatment centre after suicide attempts.","volume":"306","author":"Nordentoft","year":"1993","journal-title":"BMJ"},{"key":"R11-29-20250326","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1192\/bjp.146.4.395","article-title":"Repetition of self poisoning and subsequent death in adolescents who take overdoses.","volume":"146","author":"Goldcare","year":"1985","journal-title":"Br J Psychiatry"},{"key":"R12-29-20250326","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.mcna.2008.03.005","article-title":"Acute liver failure including acetaminophen overdose.","volume":"92","author":"Fontana","year":"2008","journal-title":"Med Clin North Am"},{"key":"R13-29-20250326","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/bmj.303.6796.221","article-title":"Liver transplantation after paracetamol overdose.","volume":"303","author":"OGrady","year":"1991","journal-title":"BMJ"},{"key":"R14-29-20250326","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1136\/gut.35.6.809","article-title":"Serious paracetamol poisoning and the results of liver transplantation.","volume":"35","author":"Mutimer","year":"1994","journal-title":"Gut"},{"key":"R15-29-20250326","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.iccn.2007.03.005","article-title":"A qualitative study exploring patients perceived quality of life following an emergency liver transplant for acute liver failure.","volume":"23","author":"Sargent","year":"2007","journal-title":"Intensive Crit Care Nurs"},{"key":"R16-29-20250326","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1086\/JCE199607309","article-title":"Should a patient who attempted suicide receive a liver transplant?","volume":"7","author":"Forster","year":"1996","journal-title":"J Clin Ethics"},{"key":"R17-29-20250326","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/S0163-8343(03)00090-2","article-title":"Psychiatric considerations in the patient receiving organ transplantation: a clinical case conference.","volume":"25","author":"Huffman","year":"2003","journal-title":"Gen Hosp Psychiatry"},{"key":"R18-29-20250326","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1136\/bmj.317.7152.172","article-title":"Assessing priorities for allocation of donor liver grafts: survey of public and clinicians.","volume":"317","author":"Neuberger","year":"1998","journal-title":"BMJ"},{"key":"R19-29-20250326","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1002\/lt.21247","article-title":"Employment and quality of life in liver transplant recipients.","volume":"13","author":"Saab","year":"2007","journal-title":"Liver Transpl"},{"key":"R20-29-20250326","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1192\/bjp.156.3.399","article-title":"Why parasuicides repeat despite problem resolution.","volume":"156","author":"Sakinofsky","year":"1990","journal-title":"Br J Psychiatry"},{"key":"R21-29-20250326","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/j.1600-0447.2003.00282.x","article-title":"A multivariate study of predictors of repeat parasuicide.","volume":"109","author":"Colman","year":"2004","journal-title":"Acta Psychiatr Scand"},{"key":"R22-29-20250326","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1176\/appi.ajp.161.3.562","article-title":"Completed suicide after a suicide attempt: a 37year followup study.","volume":"161","author":"Suominen","year":"2004","journal-title":"Am J Psychiatry"},{"key":"R23-29-20250326","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0163-8343(00)00098-0","article-title":"Noncompliance in organ transplant recipients: a literature review.","volume":"22","author":"LaederachHoffman","year":"2000","journal-title":"Gen Hosp Psychiatry"},{"key":"R24-29-20250326","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1002\/lt.20828","article-title":"Adherence to medication after liver transplantation in Scotland: a pilot study.","volume":"12","author":"OCarroll","year":"2006","journal-title":"Liver Transpl"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.21799","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.21799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-200910000-00029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T12:11:10Z","timestamp":1743250270000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-200910000-00029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,10]]},"references-count":24,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2009]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.21799","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2009,10]]}}}