{"title":"对2016年至2021年日本急性肝衰竭和晚发性肝衰竭患者的全国性调查。","authors":"Nobuaki Nakayama, Masamitsu Nakao, Yoshihito Uchida, Akio Ido, Yasuhiro Takikawa, Keisuke Kakisaka, Naoya Kato, Kazuaki Chayama, Kazuaki Inoue, Mureo Kasahara, Shuji Terai, Hiromasa Ohira, Isao Sakaida, Taro Takami, Kiyoshi Hasegawa, Masanori Abe, Masahito Shimizu, Hitoshi Yoshiji, Takuya Genda, Ayano Inui, Ryuzo Abe, Hajime Takikawa, Atsushi Tanaka, Satoshi Mochida","doi":"10.1111/hepr.14191","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>A nationwide survey was conducted to clarify the recent status of patients with acute liver failure (ALF) and late-onset fulminant hepatitis (LOHF) in Japan.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Two-step surveys were performed annually targeting 782 hospitals, focusing on patients meeting the Japanese diagnostic criteria.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1404 patients seen between 2016 and 2021 were enrolled, including 1373 patients with ALF (824 non-comatose, 320 acute type, and 229 subacute type) and 31 patients with LOHF. Of these, 1117 patients (79.6%) had hepatitis, and 287 patients (20.4%) did not have hepatitis. Compared to patients seen from 2010 to 2015, those from 2016 to 2021 showed a decrease in the proportion of viral cases across all types compared to those up to 2009, whereas the proportion of drug-induced, autoimmune, and indeterminate cases increased. Among the patients, 32 had HBV reactivation due to immunosuppressive and/or antineoplastic therapies (17 HBsAg positive and 15 HBsAg negative). The frequency of complications and various treatment methods did not show significant changes compared to previous surveys. Excluding non-comatose cases, the survival rate with medical treatment for patients with and without hepatitis remained low. Liver transplantation was performed in 144 patients with hepatitis (12.9%) and in 19 patients without hepatitis (6.6%). Multivariate analysis identified disease types, patient age, etiology, liver atrophy, and complications as factors associated with the outcome.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Although the clinical features and etiologies of patients with ALF and LOHF have evolved, patient outcomes have not improved in recent years.</p>\n </section>\n </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 6","pages":"932-947"},"PeriodicalIF":3.4000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14191","citationCount":"0","resultStr":"{\"title\":\"Nationwide survey of patients with acute liver failure and late-onset hepatic failure in Japan seen between 2016 and 2021\",\"authors\":\"Nobuaki Nakayama, Masamitsu Nakao, Yoshihito Uchida, Akio Ido, Yasuhiro Takikawa, Keisuke Kakisaka, Naoya Kato, Kazuaki Chayama, Kazuaki Inoue, Mureo Kasahara, Shuji Terai, Hiromasa Ohira, Isao Sakaida, Taro Takami, Kiyoshi Hasegawa, Masanori Abe, Masahito Shimizu, Hitoshi Yoshiji, Takuya Genda, Ayano Inui, Ryuzo Abe, Hajime Takikawa, Atsushi Tanaka, Satoshi Mochida\",\"doi\":\"10.1111/hepr.14191\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>A nationwide survey was conducted to clarify the recent status of patients with acute liver failure (ALF) and late-onset fulminant hepatitis (LOHF) in Japan.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Two-step surveys were performed annually targeting 782 hospitals, focusing on patients meeting the Japanese diagnostic criteria.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 1404 patients seen between 2016 and 2021 were enrolled, including 1373 patients with ALF (824 non-comatose, 320 acute type, and 229 subacute type) and 31 patients with LOHF. Of these, 1117 patients (79.6%) had hepatitis, and 287 patients (20.4%) did not have hepatitis. Compared to patients seen from 2010 to 2015, those from 2016 to 2021 showed a decrease in the proportion of viral cases across all types compared to those up to 2009, whereas the proportion of drug-induced, autoimmune, and indeterminate cases increased. Among the patients, 32 had HBV reactivation due to immunosuppressive and/or antineoplastic therapies (17 HBsAg positive and 15 HBsAg negative). The frequency of complications and various treatment methods did not show significant changes compared to previous surveys. Excluding non-comatose cases, the survival rate with medical treatment for patients with and without hepatitis remained low. Liver transplantation was performed in 144 patients with hepatitis (12.9%) and in 19 patients without hepatitis (6.6%). Multivariate analysis identified disease types, patient age, etiology, liver atrophy, and complications as factors associated with the outcome.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Although the clinical features and etiologies of patients with ALF and LOHF have evolved, patient outcomes have not improved in recent years.</p>\\n </section>\\n </div>\",\"PeriodicalId\":12987,\"journal\":{\"name\":\"Hepatology Research\",\"volume\":\"55 6\",\"pages\":\"932-947\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14191\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hepatology Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/hepr.14191\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepatology Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hepr.14191","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Nationwide survey of patients with acute liver failure and late-onset hepatic failure in Japan seen between 2016 and 2021
Aim
A nationwide survey was conducted to clarify the recent status of patients with acute liver failure (ALF) and late-onset fulminant hepatitis (LOHF) in Japan.
Methods
Two-step surveys were performed annually targeting 782 hospitals, focusing on patients meeting the Japanese diagnostic criteria.
Results
A total of 1404 patients seen between 2016 and 2021 were enrolled, including 1373 patients with ALF (824 non-comatose, 320 acute type, and 229 subacute type) and 31 patients with LOHF. Of these, 1117 patients (79.6%) had hepatitis, and 287 patients (20.4%) did not have hepatitis. Compared to patients seen from 2010 to 2015, those from 2016 to 2021 showed a decrease in the proportion of viral cases across all types compared to those up to 2009, whereas the proportion of drug-induced, autoimmune, and indeterminate cases increased. Among the patients, 32 had HBV reactivation due to immunosuppressive and/or antineoplastic therapies (17 HBsAg positive and 15 HBsAg negative). The frequency of complications and various treatment methods did not show significant changes compared to previous surveys. Excluding non-comatose cases, the survival rate with medical treatment for patients with and without hepatitis remained low. Liver transplantation was performed in 144 patients with hepatitis (12.9%) and in 19 patients without hepatitis (6.6%). Multivariate analysis identified disease types, patient age, etiology, liver atrophy, and complications as factors associated with the outcome.
Conclusion
Although the clinical features and etiologies of patients with ALF and LOHF have evolved, patient outcomes have not improved in recent years.
期刊介绍：
Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.
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