{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T14:04:54Z","timestamp":1764079494720,"version":"3.40.5"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>After the implementation of universal hepatitis A virus vaccination in Argentina, the outcome of pediatric acute liver failure (PALF) remains unknown. We aimed to identify variables associated with the risk of liver transplantation (LT) or death and to determine the causes and short\u2010term outcomes of PALF in Argentina. We retrospectively included 135 patients with PALF listed for LT between 2007 and 2016. Patients with autoimmune hepatitis (AIH), Wilson\u2019s disease (WD), or inborn errors of metabolism (IEM) were classified as PALF\u2013chronic liver disease (CLD), and others were classified as \u201cpure\u201d PALF. A logistic regression model was developed to identify factors independently associated with death or need of LT and risk stratification. The most common etiologies were indeterminate (52%), AIH (23%), WD (6%), and IEM (6%). Overall, transplant\u2010free survival was 35%, whereas 50% of the patients underwent LT and 15% died on the waiting list. The 3\u2010month risk of LT or death was significantly higher among patients with pure PALF compared with PALF\u2010CLD (76.5% versus 42.5%; relative risk, 1.8 [1.3\u20102.5]; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001), and 3 risk factors were independently associated with worse outcome: international normalized ratio (INR) \u22653.5 (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.3\u20107.2]), bilirubin \u226517\u00a0mg\/dL (OR, 4.4; 95% CI, 1.9\u201010.3]), and pure PALF (OR, 3.8; 95% CI, 1.6\u20108.9). Patients were identified by the number of risk factors: Patients with 0, 1, or \u22652 risk factors presented a 3\u2010month risk of worse outcome of 17.6%, 36.6%, and 82%, respectively. In conclusion, although lacking external validation, this simple risk\u2010staging model might help stratify patients with different transplant\u2010free survival rates and may contribute to establishing the optimal timing for LT.<\/jats:p>","DOI":"10.1002\/lt.25658","type":"journal-article","created":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T11:03:25Z","timestamp":1570964605000},"page":"268-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Changing Etiologies and Prognostic Factors in Pediatric Acute Liver Failure"],"prefix":"10.1097","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7026-9908","authenticated-orcid":false,"given":"Manuel","family":"Mendizabal","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Universitario Austral,Pilar,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Dip","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezequiel","family":"Demirdjian","sequence":"additional","affiliation":[{"name":"Sanatorio Sagrado Coraz\u00f3n,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro","family":"Lauferman","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Lopez","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Minetto","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Costaguta","sequence":"additional","affiliation":[{"name":"Sanatorio Parque,Rosario,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Rumbo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Favaloro,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivone","family":"Malla","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Universitario Austral,Pilar,Argentina"},{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Camila","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Division,Hospital Italiano de Buenos Aires,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esteban","family":"Halac","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo","family":"Cervio","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Cuarterolo","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Galoppo","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Dr. Ricardo Guti\u00e9rrez,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar","family":"Imventarza","sequence":"additional","affiliation":[{"name":"Hospital Garrahan,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana","family":"Bisgniano","sequence":"additional","affiliation":[{"name":"Instituto Nacional Central Unico Coordinador de Ablaci\u00f3n e Implante,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Division,Hospital Italiano de Buenos Aires,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Instituto de Efectividad Cl\u00ednica Sanitaria,Buenos Aires,Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"lt25658-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.cld.2018.06.009","article-title":"Acute 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