From the annual meeting of the American Surgical Association in Chicago
Scientists may be able to offer a lifeline to the roughly 2,000 Americans diagnosed each year with acute liver failure, due largely to acetaminophen overdose or acute viral hepatitis.
It is thought that the drugs may help the liver recover or lower the extent of injury that incurs. The theory has merit since stem cell mobilizing agents have been shown to be beneficial in animals with acute kidney injury and to improve heart function in humans after a heart attack.
Although the data are still very preliminary, the power of the animal work is that the drugs are patient-ready and would be used in a population with no good options, said lead researcher Dr. Andrew Cameron, surgical director of liver transplantation at Johns Hopkins University.
“These patients choose between liver transplant and death,” he said.
Forty percent of ALF patients spontaneously recover, but 60% require an urgent liver transplant and must compete with the 20,000 patients with chronic liver disease already on the transplant waiting list. Roughly 30% of patients die before they get an organ, while outcomes are suboptimal for those fortunate enough to get an organ.
In one of the largest published series on liver transplant for ALF, researchers at UCLA reported that 76% of 204 patients were comatose before liver transplant. One- and five-year survival rates were 73% and 67% . The median age of the patients was just 20 years.