{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:01:51Z","timestamp":1792839711469,"version":"4.5.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Neonatal acute liver failure (NALF), as a rare disease with high mortality, has limited relevant literature reports in China. We attempted to analyze a NALF cohort to improve the prognosis of this disease. We included all patients diagnosed with NALF at our institution between 2016 and 2021 and retrospectively reviewed their electronic records. NALF was defined as an INR\u2009\u2265\u20092.0 due to liver disease 28\u00a0days after birth. Comparisons were made according to etiology and outcome. The Kaplan-Meier method was used to estimate survival. Fifty-eight patients were included in this study. Etiologies included hypoxic\/ischemic injury (29.3%), infection (27.6%), gestational alloimmune liver disease with neonatal hemochromatosis (GALD-NH) (10.3%), inherited metabolic diseases (5.2%), hemophagocytic lymphohistiocytosis (1.7%), other etiologies (12.1%), and unidentified causes (13.8%). Enteroviruses constituted 87.5% of the viral infections, whereas herpes simplex virus accounted for no infections. The median INR was significantly lower in the infection group than in the GALD-NH group (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05 for multiple comparisons). At the last follow-up, none of the patients had undergone liver transplantation, and the overall mortality rate was 50%. Liver function completely recovered in 31% of the patients, all of whom survived. The overall median survival time was 48\u00a0days; 26\u00a0days for hypoxic\/ischemic injury and 43\u00a0days for GALD-NH. The incidence of cholestasis was significantly greater among surviving patients (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.018).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>\u00a0 \u00a0Conclusion<\/jats:italic>\n                    : Hypoxic\/ischemic injury and infection are the predominant etiologies of NALF in China. The overall prognosis of NALF is poor, but its short-term prognosis is determined by the etiology.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              <jats:italic>\u2022 Neonatal acute liver failure (NALF) is a rare disorder with limited cohort studies, especially in China.<\/jats:italic>\n                              <jats:italic>\u2022 Gestational alloimmune liver disease, viral infections (especially herpes simplex virus), metabolic diseases and ischemic insults are common etiologies of NALF, which are significantly different from other populations.<\/jats:italic>\n                              <jats:italic>\u2022 There are no reliable biochemical markers to predict the outcome of NALF.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              <jats:italic>\u2022 In this first report on a Chinese NALF cohort, we demonstrate that hypoxic\/ischemic injury and infection (excluding herpes simplex virus) are the predominant etiologies of NALF.<\/jats:italic>\n                              <jats:italic>\u2022 The overall prognosis of NALF is poor, and its etiology determines the short-term outcome.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-024-05567-7","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T21:01:58Z","timestamp":1714510918000},"page":"3211-3218","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical characteristics and outcomes of acute liver failure in neonates: a retrospective cohort in China"],"prefix":"10.1007","volume":"183","author":[{"given":"Suhua","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqiang","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"issue":"5","key":"5567_CR1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.dld.2021.03.004","volume":"53","author":"A Di Giorgio","year":"2021","unstructured":"Di Giorgio A, Bartolini E, Calvo PL et al (2021) Diagnostic Approach to Acute Liver Failure in Children: A Position Paper by the SIGENP Liver Disease Working Group. 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