Evidence map›Paper›PMID 39112909›Full record

ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2025

Current status of etiology and outcomes of acute liver failure in India-A multicentre study from tertiary centres.

Akash Roy, Karan Kumar, Madhumita Premkumar, Amarthya Sree, Anand Gupta, Mithun Sharma, Manasa Alla, Sowmya Iyengar, Shantan Venishetty, Uday C Ghoshal and 7 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Reply to the letter "Therapeutic plasma exchange in hepatitis A-related acute liver failure: Does study design influence interpretation?"Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Article
  3. Article
  4. Article
  5. Hepatitis A: A wake-up call!Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Article
  6. Clinical, economic and social impact of hepatitis A virus: Impact of gastrointestinal co-infections on disease course.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Akash RoyInstitute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
Karan KumarDepartment of Hepatology, Mahatma Gandhi Medical College, Jaipur, 302 022, India.
Madhumita PremkumarDepartment of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Amarthya SreeDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Anand GuptaDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Mithun SharmaDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Manasa AllaDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Sowmya IyengarDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Shantan VenishettyDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Uday C GhoshalInstitute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
Mahesh GoenkaInstitute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
Padaki Nagaraja RaoDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Vivek Anand SaraswatDepartment of Hepatology, Mahatma Gandhi Medical College, Jaipur, 302 022, India.
Nageshwar Duvvur ReddyDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India.
Anand V KulkarniDepartment of Hepatology and Liver Transplantation, AIG Hospitals, Hyderabad, 500 032, India. anandvk90@gmail.com.ORCID 0000-0002-1240-1675
Rajender K ReddyDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
HEPIN consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsAcute liver failure (ALF) is a medical emergency and liver transplantation (LT) may be required as definitive therapy. The etiology varies across geographical locations and is mostly viral dominant in India. We aimed at evaluating the spectrum, impact of interventions (plasma exchange [PLEx], continuous renal replacement therapy [CRRT]) and outcomes of ALF in India in recent times.

methodsA multicentre retrospective study across four major tertiary care centres.

resultsAs many as 183 ALF patients (median age, 23 years; females, 43.1%; model for end-stage liver disease [MELD], 32.7) from January 2021 to December 2023 were included. Nineteen per cent had infection and 40.4% of patients satisfied King's College criteria (KCC) at admission. Most common cause for ALF was hepatitis A virus (HAV) (44.2%) followed by rodenticide poisoning (10.3%). Approximately 35% of patients each received either PLEx or CRRT. The 7, 14 and 21-day transplant-free survival probability was 65.5%, 60.1%, and 57.3%, respectively. Only 3.8% of patients underwent liver transplantation. On multivariable Cox regression analysis, hemoglobin (HR, 0.74 [0.63-0.87]), lactate (HR, 1.14 [1.03-1.26]), advanced hepatic encephalopathy (HE) (HR, 4.87 [1.89-12.5]) and fulfilling KCC [HR, 10.04 [4.57-22.06]) at admission were the independent predictors of mortality. A model including KCC + lactate + HE ≥ 3 with or without hemoglobin had an AUROC of 0.81-0.84 to predict mortality. In those who underwent PLEx, advanced HE (HR, 4.13 [1.75-9.7]), procalcitonin (HR, 1.18 [1.07-1.30]) and KCC (HR, 4.6 [1.6-13.1), while for those who received CRRT, lactate (HR, 1.37 [1.22-1.54]) and KCC (HR, 6.4 [2.5-15.8]) independently predicted mortality.

conclusionsHepatitis A virus is currently the most common cause for ALF in India, emphasizing the need for universal vaccination programmes. Spontaneous survival in tertiary care centres is 57%. LT rates were low.

Indexed as

Liver Failure, AcuteAdolescentAdultFemaleHepatitis AHumansIndiaLiver TransplantationMaleMiddle AgedPlasma ExchangeRenal Replacement TherapyRetrospective StudiesTertiary Care CentersTreatment OutcomeYoung AdultCRRTHepatitis A virusKing’s College criteriaPlasma exchange

Identifiers

PMID39112909

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.