Liver Transplantation Society of India Guidelines for the Management of Acute Liver Injury Secondary to Yellow Phosphorus-Containing Rodenticide Poisoning Using the Modified Delphi Technique of Consensus Development.

ALF, acute liver failure ALI, acute liver injury DDLT, deceased donor liver transplantation ICU, intensive care unit INR, international normalised ratio KCC, Kings College Criteria LDLT, living donor liver transplantation LT, liver transplantation LTSI, Liver Transplantation Society of India MELD, model for end-stage liver disease RRT, renal replacement therapy TPE, therapeutic plasma exchange YP, yellow phosphorus acute liver failure consensus guidelines liver transplantation rat killer poison yellow phosphorus

Journal

Journal of clinical and experimental hepatology
ISSN: 0973-6883
Titre abrégé: J Clin Exp Hepatol
Pays: India
ID NLM: 101574137

Informations de publication

Date de publication:
Historique:
received: 10 06 2020
accepted: 28 09 2020
entrez: 19 7 2021
pubmed: 20 7 2021
medline: 20 7 2021
Statut: ppublish

Résumé

Acute liver failure caused by the ingestion of yellow phosphorus-containing rodenticide has been increasing in incidence over the last decade and is a common indication for emergency liver transplantation in Southern and Western India and other countries. Clear guidelines for its management are necessary, given its unpredictable course, potential for rapid deterioration and variation in clinical practice. A modified Delphi approach was used for developing consensus guidelines under the aegis of the Liver Transplantation Society of India. A detailed review of the published literature was performed. Recommendations for three areas of clinical practice, assessment and initial management, intensive care unit (ICU) management and liver transplantation, were developed. The expert panel consisted of 16 clinicians, 3 nonclinical specialists and 5 senior advisory members from 11 centres. Thirty-one recommendations with regard to criteria for hospital admission and discharge, role of medical therapies, ICU management, evidence for extracorporeal therapies such as renal replacement therapy and therapeutic plasma exchange, early predictors of need for liver transplantation and perioperative care were developed based on published evidence and combined clinical experience. Development of these guidelines should help standardise care for patients with yellow phosphorus poisoning and identify areas for collaborative research.

Sections du résumé

BACKGROUND BACKGROUND
Acute liver failure caused by the ingestion of yellow phosphorus-containing rodenticide has been increasing in incidence over the last decade and is a common indication for emergency liver transplantation in Southern and Western India and other countries. Clear guidelines for its management are necessary, given its unpredictable course, potential for rapid deterioration and variation in clinical practice.
METHODS METHODS
A modified Delphi approach was used for developing consensus guidelines under the aegis of the Liver Transplantation Society of India. A detailed review of the published literature was performed. Recommendations for three areas of clinical practice, assessment and initial management, intensive care unit (ICU) management and liver transplantation, were developed.
RESULTS RESULTS
The expert panel consisted of 16 clinicians, 3 nonclinical specialists and 5 senior advisory members from 11 centres. Thirty-one recommendations with regard to criteria for hospital admission and discharge, role of medical therapies, ICU management, evidence for extracorporeal therapies such as renal replacement therapy and therapeutic plasma exchange, early predictors of need for liver transplantation and perioperative care were developed based on published evidence and combined clinical experience.
CONCLUSION CONCLUSIONS
Development of these guidelines should help standardise care for patients with yellow phosphorus poisoning and identify areas for collaborative research.

Identifiants

pubmed: 34276154
doi: 10.1016/j.jceh.2020.09.011
pii: S0973-6883(20)30150-X
pmc: PMC8267358
doi:

Types de publication

Journal Article

Langues

eng

Pagination

475-483

Informations de copyright

© 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.

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Auteurs

Mettu S Reddy (MS)

Institute of Liver Disease & Transplantation, Dr Rela Institute & Medical Center, Chennai, India.

Akila Rajakumar (A)

Department of Liver Anesthesia & Intensive Care, Dr Rela Institute & Medical Center, Chennai, India.

Johns S Mathew (JS)

Department of Liver Transplantation & Gastrointestinal Surgery, Amrita Hospitals, Kochi, India.

L Venkatakrishnan (L)

Department of Gastroenterology, PSG Hospitals, Coimbatore, India.

Dinesh Jothimani (D)

Department of Hepatology, Dr Rela Institute & Medical Center, Chennai, India.

S Sudhindran (S)

Department of Liver Transplantation & Gastrointestinal Surgery, Amrita Hospitals, Kochi, India.

Mathew Jacob (M)

Multiorgan Transplantation & Hepatobiliary Surgery, Aster Medicity, Kochi, India.

Krishnasamy Narayanasamy (K)

Department of Hepatology, Madras Medical College, Chennai, India.

Radhika Venugopal (R)

Department of Hepatology, Dr Rela Institute & Medical Center, Chennai, India.

Ravi Mohanka (R)

Department of Liver Transplantation & HPB Surgery, Global Hospital, Mumbai, India.

Ilankumaran Kaliamoorthy (I)

Department of Liver Anesthesia & Intensive Care, Dr Rela Institute & Medical Center, Chennai, India.

Joy Varghese (J)

Department of Hepatology & Liver Transplantation, Gleneagles Global Hospital & Health City, Chennai, India.

Charles Panackel (C)

Department of Hepatology & Liver Transplantation, Aster Medicity, Kochi, India.

Zubair Mohamed (Z)

Department of Anesthesiology & Critical Care Medicine, Amrita Hospitals, Kochi, India.

Mukul Vij (M)

Department of Pathology & Laboratory Medicine, Dr Rela Institute & Medical Center, Chennai, India.

Deepti Sachan (D)

Department of Transfusion Medicine, Dr Rela Institute & Medical Center, Chennai, India.

V V Pillay (VV)

Department of Forensic Medicine & Toxicology, Amrita Hospitals, Kochi, India.

Sanjiv Saigal (S)

Department of Hepatology & Liver Transplantation, Medanta Medicity, Gurgaon, India.

Radhakrishna Dhiman (R)

Department of Hepatology & Liver Transplantation, Post-graduate Institute of Medical Education & Research, Chandigarh, India.

Arvinder S Soin (AS)

Department of Liver Transplantation & Regenerative Medicine, Medanta Medicity, Gurgaon, India.

Subhash Gupta (S)

Centre for Liver & Biliary Sciences, Max Super Specialty Hospital, Saket, Delhi, India.

Julia Wendon (J)

Institute of Liver Studies, Kings College Hospital, London, UK.

Mohamed Rela (M)

Institute of Liver Disease & Transplantation, Dr Rela Institute & Medical Center, Chennai, India.

Shiv K Sarin (SK)

Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi, India.

Classifications MeSH