Values for total lactate dehydrogenase (LD, EC 1.1.1.27) and LD isoenzyme-5 were determined in serum of 106 patients with benign hepatic disorders, 54 of whom had acute liver disorders, either acute hepatitis (39 patients) or acute circulatory disturbances (15 patients). Fifty-two had chronic hepatic disorders, either cirrhosis (25 patients) or chronic right heart failure (27 patients). Overall...

We report a four year old boy who presented with liver failure secondary to anti-thrombin III deficiency related Budd Chiari syndrome. He was treated with TIPSS (transjugular intrahepatic porto systemic shunt) which reversed the encephalopathy, normalised the liver function and improved growth, pre-empting the need for a liver transplantation. This is the first reported case of TIPSS in a child...

Liver disease is a major source of morbidity and mortality in the intensive care unit (ICU). Cirrhotic patients admitted to the medical ICU have increased mortality (40 to 90%) and a poor prognosis (1). This article addresses specific management issues for conditions the intensivist is often called on to treat, including fulminant hepatic failure, complications of chronic liver disease such as ...

A 16-yr-old girl received liver transplantation for fulminant hepatitis. Aplastic anemia developed, and she received hematopoietic stem cell transplantation (HSCT). Eleven months after liver transplantation, abdominal lymph node enlargement and colon ulcers were observed, and colon biopsy showed posttransplant lymphoproliferative disorder (PTLD). Immunosuppression reduction was attempted, but i...

A noninvasive test is needed to assess the severity of encephalopathy during fulminant hepatic failure. This feasibility study was designed to compare a noninvasive test, brain lactate measurement by magnetic resonance spectroscopy, with intracranial pressure monitoring in a large animal model of fulminant hepatic failure. Five dogs received an intraventricular catheter for intracranial pressur...

urine. Hepatocytes, which are the predominant cell type within the liver, account for two-thirds of the liver mass. The liver is normally able to regenerate after acute injury and regain its function under appropriate physiological stimuli.1 However, when the normal regenerative process is compromised and the residual functional capacity of the damaged liver is unable to sustain life, liver fai...

Of 48 patients with fulminant hepatic failure who progressed to grade III or IV encephalopathy 38 showed evidence of renal impairment. In 32 of these patients the underlying cause could be placed initially into one of three categories-prerenal uraemia (4 patients), acute tubular necrosis (16), and "functional renal failure" (12). The latter differed in several respects from that seen with liver...

Owing to the wide availability of acetaminophen, intentional and unintentional overdoses are one of the leading causes of liver failure in the world [2]. NAC is currently a highly effective and safe antidote to treat acute acetaminophen overdose, and is most efficacious when administered within 8 hours of ingestion [3]. Furthermore, one landmark study showed that even in patients who presented ...