Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and Acute Liver Failure.

Chalermrat Bunchorntavakul, K Rajender Reddy

Journal: Clinics in liver disease 2019;22(2):325-346

PMID: 29605069

Full Text on Elsevier Science View on PubMed

Abstract

Acetaminophen (APAP) is the leading cause of acute liver failure (ALF), although the worldwide frequency is variable. APAP hepatotoxicity develops either following intentional overdose or unintentional ingestion (therapeutic misadventure) in the background of several factors, such as concomitant use of alcohol and certain medications that facilitate the formation of reactive and toxic metabolites. Spontaneous survival is more common in APAP-induced ALF compared with non-APAP etiologies. N-acetylcysteine is recommended for all patients with APAP-induced ALF and it reduces mortality. Liver transplantation should be offered early to those who are unlikely to survive based on described prognostic criteria.

Address: Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA; Division of Gastroenterology and Hepatology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Rajavithi Road, Ratchathewi, Bangkok 10400, Thailand.; Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: [email protected].

DOI: 10.1016/j.cld.2018.01.007

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MeSH Terms: Acetaminophen, Acetylcysteine, Biomarkers, Humans, Liver Failure, Acute, Liver Transplantation