A team of researchers led by Dr. Robert Fontana from the University of Michigan Medical Center in Ann Arbor conducted a prospective observational study on patients who were diagnosed with acute liver failure (ALF) to better understand the quality of life and function of adult ALF survivors. These patients were diagnosed with ALF between January 1998 and July 2010 and they were asked to participate in follow-up studies at one and two years following their ALF.
This study was funded in part by a grant from the National Institute of Diabetes, Digestive and Kidney Diseases to the United States Acute Liver failure Study Group (ALFSG). ALFSG is a National Institutes of Health-funded consortium of investigators in the United States focused on studying acute liver failure, and is headed by Dr. William Lee, professor of Internal Medicine at UT Southwestern Medical Center in Dallas.
According to a recent study published online in Liver Transplantation, spontaneous survivors of acetaminophen overdose have lower overall health compared to survivors or transplant recipients following ALF generated by non-drug induced liver damage. This report reveals that acetaminophen overdose survivors have greater impaired mental function and poorer physical health as well as activity limitations due to pain, anxiety and depression.
A patient is diagnosed with ALF when severe liver damage occurs. This includes blood clotting and brain dysfunction. It is reported that some 3,000 patients develop ALF in the U.S. each year. It is also reported that 67 percent will survive, however, around 30 percent will require liver transplantation.
The current study reveals that of the 282 ALF patients 125 received liver transplants of which 10.7 percent were due to an acetaminophen overdose and 157 patients who were spontaneous survivors of which 95 were acetaminophen overdoses and 62 were survivors of non-drug induced liver dysfunction.
Non-acetaminophen overdose survivors and transplant recipients had better general health scores. Acetaminophen overdose survivors had higher rates of substance abuse and psychiatric disease. It is also reported that survivors of non-intentional acetaminophen overdose were less like to have psychiatric comorbidity as compared to patients who intentionally overdosed at 48 percent and 82 percent, respectively.
Fontana concludes, “Our findings indicate that adult survivors of ALF have reduced quality of life compared to those of similar age and gender in the general population. Additional investigations of brain function by our team are underway to further understanding of the type and severity of cognitive impairment reported by ALF survivors.”