@article{ref1,
title="Amanita phalloides poisoning: reassessment of prognostic factors and indications for emergency liver transplantation",
journal="Journal of hepatology",
year="2007",
author="Escudié, Luc and Francoz, Claire and Vinel, Jean-Pierre and Moucari, Rami and Cournot, Maxime and Paradis, Valérie and Sauvanet, Alain and Belghiti, Jacques and Valla, Dominique and Bernuau, Jacques and Durand, François",
volume="46",
number="3",
pages="466-473",
abstract="BACKGROUND/AIMS: Amanita phalloides poisoning is an uncommon cause of acute liver failure with an especially rapid course. The aim of this study was to re-assess transplantation criteria in patients with mushroom poisoning. METHODS: Twenty-seven patients admitted for Amanita phalloides poisoning were studied. Previously reported transplantation criteria, including the recent Ganzert's criteria, were tested retrospectively. RESULTS: The rate of fatal intoxication (death and/or transplantation) was 8/27 (30%). An interval between ingestion and diarrhea <8h was a very early predictor of a fatal outcome (accuracy of 78%). Later on, non-paracetamol and paracetamol King's College criteria were superior to Clichy's and Ganzert's criteria (accuracy of 100% compared to 85% and 85%, respectively). Encephalopathy and renal insufficiency were not constant in the fatal intoxication group. Prothrombin index below 10% 4 days or more after ingestion had a 100% accuracy for predicting a fatal outcome. CONCLUSIONS: Liver transplantation should be strongly considered in patients with an interval between ingestion and diarrhea <8h. Encephalopathy should not be an absolute prerequisite for deciding transplantation. From day 4 after ingestion, prothrombin index lower than 10% ( approximately INR of 6) alone is a reliable tool for deciding emergency transplantation.<p /><p>Language: en</p>",
language="en",
issn="0168-8278",
doi="10.1016/j.jhep.2006.10.013",
url="http://dx.doi.org/10.1016/j.jhep.2006.10.013"
}