Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan
Abstract Background and Aim In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late‐onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12508 |
| _version_ | 1818595084540575744 |
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| author | Takuro Hisanaga Isao Hidaka Isao Sakaida Nobuaki Nakayama Akio Ido Naoya Kato Yasuhiro Takikawa Kazuaki Inoue Masahito Shimizu Takuya Genda Shuji Terai Hirohito Tsubouchi Hajime Takikawa Satoshi Mochida Intractable Hepato‐Biliary Disease Study Group of Japan |
| author_facet | Takuro Hisanaga Isao Hidaka Isao Sakaida Nobuaki Nakayama Akio Ido Naoya Kato Yasuhiro Takikawa Kazuaki Inoue Masahito Shimizu Takuya Genda Shuji Terai Hirohito Tsubouchi Hajime Takikawa Satoshi Mochida Intractable Hepato‐Biliary Disease Study Group of Japan |
| author_sort | Takuro Hisanaga |
| collection | DOAJ |
| description | Abstract Background and Aim In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late‐onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the influence of corticosteroids on patient outcomes after liver transplantation was investigated. Methods This study included 167 patients with acute liver failure and late‐onset hepatic failure who underwent liver transplantation between 2010 and 2015. The effects of pretransplant corticosteroid therapy on patient outcomes were evaluated using a database constructed by the subcommittee for fulminant hepatitis in the Intractable Hepato‐Biliary Diseases Study Group of Japan. Results The subacute type and the median total bilirubin levels were higher in those receiving corticosteroids than in those not receiving corticosteroids. Although infections tended to be higher in patients receiving corticosteroids, pretransplant corticosteroid administration did not affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients who developed infections. The survival rates, however, did not differ between patients with and without infections. Conclusions Corticosteroids were administered to patients with poor prognoses. Otherwise, the overall outcome in those administered corticosteroids was not significantly different from that in those administered without corticosteroids. Although infectious complications tended to occur, they were generally controllable and nonfatal. Pretransplant corticosteroid therapy may be permissible, with regarding for infections and performed within the minimum duration. |
| first_indexed | 2024-12-16T11:10:24Z |
| format | Article |
| id | doaj.art-0d4366d872a644fdb3f7e6e505aa7ffc |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-16T11:10:24Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-0d4366d872a644fdb3f7e6e505aa7ffc2022-12-21T22:33:45ZengWileyJGH Open2397-90702021-04-015442843310.1002/jgh3.12508Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in JapanTakuro Hisanaga0Isao Hidaka1Isao Sakaida2Nobuaki Nakayama3Akio Ido4Naoya Kato5Yasuhiro Takikawa6Kazuaki Inoue7Masahito Shimizu8Takuya Genda9Shuji Terai10Hirohito Tsubouchi11Hajime Takikawa12Satoshi Mochida13Intractable Hepato‐Biliary Disease Study Group of JapanDepartment of Gastroenterology and Hepatology Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Gastroenterology and Hepatology Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Gastroenterology and Hepatology Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Gastroenterology and Hepatology Saitama Medical University Saitama JapanDigestive and Lifestyle Diseases Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima JapanDepartment of Gastroenterology, Graduate School of Medicine Chiba University Chiba JapanDivision of Hepatology, Department of Internal Medicine Iwate Medical University Morioka JapanDepartment of Gastroenterology International University of Health and Welfare Narita JapanDepartment of Gastroenterology and Hematology Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Izunokuni JapanDivision of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University Niigata JapanDepartment of Gastroenterology and Hepatology Kagoshima City Hospital Kagoshima JapanFaculty of Medical Technology Teikyo University Tokyo JapanDepartment of Gastroenterology and Hepatology Saitama Medical University Saitama JapanAbstract Background and Aim In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late‐onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the influence of corticosteroids on patient outcomes after liver transplantation was investigated. Methods This study included 167 patients with acute liver failure and late‐onset hepatic failure who underwent liver transplantation between 2010 and 2015. The effects of pretransplant corticosteroid therapy on patient outcomes were evaluated using a database constructed by the subcommittee for fulminant hepatitis in the Intractable Hepato‐Biliary Diseases Study Group of Japan. Results The subacute type and the median total bilirubin levels were higher in those receiving corticosteroids than in those not receiving corticosteroids. Although infections tended to be higher in patients receiving corticosteroids, pretransplant corticosteroid administration did not affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients who developed infections. The survival rates, however, did not differ between patients with and without infections. Conclusions Corticosteroids were administered to patients with poor prognoses. Otherwise, the overall outcome in those administered corticosteroids was not significantly different from that in those administered without corticosteroids. Although infectious complications tended to occur, they were generally controllable and nonfatal. Pretransplant corticosteroid therapy may be permissible, with regarding for infections and performed within the minimum duration.https://doi.org/10.1002/jgh3.12508acute liver failurecorticosteroidlate‐onset hepatic failureliver transplantation |
| spellingShingle | Takuro Hisanaga Isao Hidaka Isao Sakaida Nobuaki Nakayama Akio Ido Naoya Kato Yasuhiro Takikawa Kazuaki Inoue Masahito Shimizu Takuya Genda Shuji Terai Hirohito Tsubouchi Hajime Takikawa Satoshi Mochida Intractable Hepato‐Biliary Disease Study Group of Japan Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan JGH Open acute liver failure corticosteroid late‐onset hepatic failure liver transplantation |
| title | Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan |
| title_full | Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan |
| title_fullStr | Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan |
| title_full_unstemmed | Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan |
| title_short | Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan |
| title_sort | analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late onset hepatic failure in japan |
| topic | acute liver failure corticosteroid late‐onset hepatic failure liver transplantation |
| url | https://doi.org/10.1002/jgh3.12508 |
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