Nigerian Journal of Clinical Practice

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 21  |  Issue : 7  |  Page : 888--893

Significance and outcome of living-donor liver transplantation in acute mushroom intoxication


A Baskiran, A Dirican, D Ozgor, M Kement, S Koc, TT Sahin, M Ates, S Yilmaz 
 Department of General Surgery, Inonu University Turgut Ozal Medical Center, Faculty of Medicine, Institute of Liver Transplantation, Malatya, Turkey

Correspondence Address:
Dr. A Baskiran
Department of General Surgery, Inonu University Turgut Ozal Medical Center, Faculty of Medicine, Institute of Liver Transplantation, Malatya
Turkey

Introduction: Mushroom intoxication (MT) can lead to acute liver injury which may result in Mushroom intoxication-related liver failure (M-ALF) requiring liver transplantation (LT). In the present study, we want to share the experience of our institute regarding living-donor LT (LDLT) due to mushroom poisoning. Aim: The aim of this study is to identify the predictors of poor prognosis in patients with ALF secondary to mushroom intoxication requiring LDLT. Materials and Methods: All patients with MT between 2008 and 2016 were evaluated. Demographics, symptoms, interval between symptoms and admission to our institute, laboratory data, model for end-stage liver disease (MELD)/pediatric end-stage liver disease (PELD) scores, clinical course, and outcomes of supportive therapy and LT were evaluated. There were two groups in the study: Group A = responsive to supportive therapy (n = 9) versus Group B = unresponsive to supportive therapy (n = 9). Results: During the study, a total of 18 patients were admitted with M-ALF. Twelve (66.7%) of them were female, and the mean age was 39.9 ± 18.2 years. All of the nine patients in Group A fully recovered with supportive therapy. In Group B, one patient died during waiting period for LT and 8 patients received LDLT LDLT. Three of the eight patients who were transplanted died in the postoperative early period within postoperative 5 days. The patients in Group B had significantly higher MELD/PELD scores and encephalopathy rate than in Group A (P < 0.05). International normalized ratio (INR), bilirubin, ammonium levels, and platelet count were significantly different between groups (P < 0.05). The patients in Group B had significantly longer interval before admission to our institute (P < 0.05). Conclusion: The presence of encephalopathy, higher MELD/PELD, INR, bilirubin, ammonium levels, and lower platelet count was related to poor prognosis in MT. LDLT provides a good therapeutic option in patients with M-ALF. The time is a crucial factor in successful treatment of MT. Early admission to a tertiary referral center with expertise in LT results in a better prognosis and increased survival following M-ALF.


How to cite this article:
Baskiran A, Dirican A, Ozgor D, Kement M, Koc S, Sahin T T, Ates M, Yilmaz S. Significance and outcome of living-donor liver transplantation in acute mushroom intoxication.Niger J Clin Pract 2018;21:888-893


How to cite this URL:
Baskiran A, Dirican A, Ozgor D, Kement M, Koc S, Sahin T T, Ates M, Yilmaz S. Significance and outcome of living-donor liver transplantation in acute mushroom intoxication. Niger J Clin Pract [serial online] 2018 [cited 2022 Aug 8 ];21:888-893
Available from: https://www.njcponline.com/article.asp?issn=1119-3077;year=2018;volume=21;issue=7;spage=888;epage=893;aulast=Baskiran;type=0