TY - JOUR
T1 - Transcatheter arterial steroid injection therapy improves the prognosis of patients with acute liver failure
AU - Kuwano, Akifumi
AU - Okui, Tasuku
AU - Kohjima, Motoyuki
AU - Kurokawa, Miho
AU - Goya, Takeshi
AU - Tanaka, Masatake
AU - Aoyagi, Tomomi
AU - Takahashi, Motoi
AU - Imoto, Koji
AU - Tashiro, Shigeki
AU - Suzuki, Hideo
AU - Fujita, Nobuhiro
AU - Ushijima, Yasuhiro
AU - Ishigami, Kousei
AU - Tokunaga, Shoji
AU - Kato, Masaki
AU - Ogawa, Yoshihiro
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/3/10
Y1 - 2023/3/10
N2 - Acute liver failure (ALF) is a disorder defined by coagulopathy and encephalopathy with a poor prognosis. No effective therapies have been established except for liver transplantation. We previously reported a subgroup of patients with acute liver injury who developed microcirculatory disturbance. We also established and reported transcatheter arterial steroid injection therapy (TASIT) as a new treatment of ALF. Here, we analyze the effectiveness of TASIT in a larger cohort and evaluate the impact on ALF patients with or without microcirculatory disturbance. We conducted a single-center retrospective study to evaluate the effectiveness of TASIT in patients with ALF admitted at Kyushu University Hospital between January 2005 and March 2018. TASIT is performed by injecting methylprednisolone via the proper hepatic artery for 3 days. One hundred ninety-4 patients with ALF were enrolled and analyzed in this study. Of the 87 patients given TASIT, 71 (81.6%) recovered without any complications and 16 (18.4%) died or underwent liver transplantation. Of the 107 patients not administered TASIT, 77 (72.0%) recovered and 30 (28.0%) progressed to irreversible liver failure. In the high-lactate dehydrogenase subgroup, 52 (86.7%) of the 60 patients with TASIT recovered, and the survival rate was significantly higher than that in patients who did not receive TASIT. Multivariate regression analysis revealed that the TASIT procedure was one of the significant prognostic factors in the high-lactate dehydrogenase subgroup and was significantly associated with prothrombin activity percentage improvement. TASIT is an effective treatment for patients with ALF, especially in those with microcirculatory disturbance.
AB - Acute liver failure (ALF) is a disorder defined by coagulopathy and encephalopathy with a poor prognosis. No effective therapies have been established except for liver transplantation. We previously reported a subgroup of patients with acute liver injury who developed microcirculatory disturbance. We also established and reported transcatheter arterial steroid injection therapy (TASIT) as a new treatment of ALF. Here, we analyze the effectiveness of TASIT in a larger cohort and evaluate the impact on ALF patients with or without microcirculatory disturbance. We conducted a single-center retrospective study to evaluate the effectiveness of TASIT in patients with ALF admitted at Kyushu University Hospital between January 2005 and March 2018. TASIT is performed by injecting methylprednisolone via the proper hepatic artery for 3 days. One hundred ninety-4 patients with ALF were enrolled and analyzed in this study. Of the 87 patients given TASIT, 71 (81.6%) recovered without any complications and 16 (18.4%) died or underwent liver transplantation. Of the 107 patients not administered TASIT, 77 (72.0%) recovered and 30 (28.0%) progressed to irreversible liver failure. In the high-lactate dehydrogenase subgroup, 52 (86.7%) of the 60 patients with TASIT recovered, and the survival rate was significantly higher than that in patients who did not receive TASIT. Multivariate regression analysis revealed that the TASIT procedure was one of the significant prognostic factors in the high-lactate dehydrogenase subgroup and was significantly associated with prothrombin activity percentage improvement. TASIT is an effective treatment for patients with ALF, especially in those with microcirculatory disturbance.
KW - acute liver failure
KW - intrahepatic microcirculatory disturbance
KW - prognosis
KW - transcatheter arterial steroid injection therapy
UR - http://www.scopus.com/inward/record.url?scp=85150079466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150079466&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000033090
DO - 10.1097/MD.0000000000033090
M3 - Article
C2 - 36897684
AN - SCOPUS:85150079466
SN - 0025-7974
VL - 102
SP - E33090
JO - Medicine (United States)
JF - Medicine (United States)
IS - 10
ER -