Akutno zatajenje jetre

master's thesis

• Title (english): Acute liver failure
• Author: Merhunisa Ramadani
• Mentor: Anna Mrzljak (mentor)
• Committee member: Mirjana Kalauz (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Akutno zatajenje jetre je rijedak entitet karakteriziran naglom i masivnom nekrozom jetre u bolesnika bez prethodne bolesti jetre koji dovodi do razvoja žutice, koagulopatije i encefalopatije, te može rezultirati progresivnim multiorganskim zatajenjem i smrti.
Najčešći uzroci akutnog zatajenja jetre u odraslih su lijekovi i virusni hepatitisi. Utvrđivanje etiologije akutnog zatajenja jetre ima ključnu ulogu u okviru liječenja jer primjena specifične terapije usmjerene na etiologiju može utjecati na ishod bolesnika, spriječiti potrebu za transplantacijom i smanjiti smrtnost. Klinički slika se razvija brzo, te se s obzirom na pojavu djeli u hiperakutno, aktuno i subakutno zatajenje. AZJ može rezultirati teškim komplikacijama poput neuroloških komplikacija, infekcija i hemodinamske nestabilnosti. Stopa preživljenja pacijenata liječenih od AZJ-e veća je od 60%. Oko 40% pacijenata preživjeti će uz pomoć simptomatskog i specifičnog liječenja, dok za one s lošom prognozom transplantacija jetre predstavlja metodu izbora. Preživljenje nakon transplantacije iznosi više od 80% unutra godine dana. Provođenjem javnozdravstvenih mjera, ranim prepoznavanjem i liječenjem pacijenata s akutnim zatajenjem jetre kao i prevencijom komplikacija poboljšavaju se rezultati i ishod bolesti. U ovom preglednom radu dat je cijelokupan osvrt na problematiku akutnog zatajenja jetre razmatrajući etiologiju, patofiziologiju, dijagnostiku, liječenje kao i prognozu ovog rijetkog ali smrtonosnog entiteta.

Abstract (english)

Acute liver failure (ALF) is an uncommon but dramatic clinical syndrome characterized by sudden and massive liver necrosis in a patient with a previously healthy liver which leads to the development of jaundice, coagulopathy and encephalopathy, and may leed to progressive multiorgan failure and death. Viral and drug-induced hepatitis are the most common causes of ALF in adults. For some causes of acute liver failure treatment aimed at the underlying cause may prevent the need for liver transplantation and decrease mortality. The signs are evolving rapidly, and based upon the velocity of the developement are graded into hyperacute, acute, and subacute form of ALF. Many patients with ALF develop a cascade of serious complications like neurological complications, infections and hemodynamic failure. Survival rates in patients treated for AFL are greater than 60%. Approximately 40% of patients survive without a liver transplantation. Liver transplantation remains the only treatment option for patients with poor prognosis. One year survival rates of the transplanted patients are greater than 80%. However, the greatest benefits in improving results and outcome of the disease will result from public health measures, early recognition and treatment of patients with acute liver failure and prevention of complications. This review gives an overview of the problem in patients with ALF considering the etiology, pathophysiology, diagnosis, treatment and prognosis of this rare but deadly entity.

• Keywords: akutno zatajenje jetre; encefalopatija; transplantacija jetre
• Keywords (english): acute liver failure; hepatic encephalopathy; liver transplantation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:959126
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-03 14:01:33