{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T10:29:34Z","timestamp":1768559374983,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH 23FC1026"],"award-info":[{"award-number":["JPMH 23FC1026"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A nationwide survey was conducted to clarify the recent status of patients with acute liver failure (ALF) and late\u2010onset fulminant hepatitis (LOHF) in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two\u2010step surveys were performed annually targeting 782 hospitals, focusing on patients meeting the Japanese diagnostic criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1404 patients seen between 2016 and 2021 were enrolled, including 1373 patients with ALF (824 non\u2010comatose, 320 acute type, and 229 subacute type) and 31 patients with LOHF. Of these, 1117 patients (79.6%) had hepatitis, and 287 patients (20.4%) did not have hepatitis. Compared to patients seen from 2010 to 2015, those from 2016 to 2021 showed a decrease in the proportion of viral cases across all types compared to those up to 2009, whereas the proportion of drug\u2010induced, autoimmune, and indeterminate cases increased. Among the patients, 32 had HBV reactivation due to immunosuppressive and\/or antineoplastic therapies (17 HBsAg positive and 15 HBsAg negative). The frequency of complications and various treatment methods did not show significant changes compared to previous surveys. Excluding non\u2010comatose cases, the survival rate with medical treatment for patients with and without hepatitis remained low. Liver transplantation was performed in 144 patients with hepatitis (12.9%) and in 19 patients without hepatitis (6.6%). Multivariate analysis identified disease types, patient age, etiology, liver atrophy, and complications as factors associated with the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the clinical features and etiologies of patients with ALF and LOHF have evolved, patient outcomes have not improved in recent years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14191","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T17:47:51Z","timestamp":1744739271000},"page":"932-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nationwide survey of patients with acute liver failure and late\u2010onset hepatic failure in Japan seen between 2016 and 2021"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1317-3272","authenticated-orcid":false,"given":"Nobuaki","family":"Nakayama","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Saitama Medical University  Moroyama\u2010Machi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-6973","authenticated-orcid":false,"given":"Masamitsu","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Saitama Medical University  Moroyama\u2010Machi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6012-0915","authenticated-orcid":false,"given":"Yoshihito","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Saitama Medical University  Moroyama\u2010Machi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Ido","sequence":"additional","affiliation":[{"name":"Digestive and Life\u2010Style Diseases Department of Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Takikawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Iwate Medical University  Yahaba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-138X","authenticated-orcid":false,"given":"Keisuke","family":"Kakisaka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Iwate Medical University  Yahaba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuaki","family":"Chayama","sequence":"additional","affiliation":[{"name":"Hiroshima Institute of Life Sciences  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuaki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology International University of Health and Welfare  Narita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mureo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Executive Director The Hospital of the National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-635X","authenticated-orcid":false,"given":"Shuji","family":"Terai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; 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