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Drug Groups Causing Liver Transplantation Identified

Study analyzes drugs causing liver transplantation and predictors of post-transplant mortality

THURSDAY, July 16 (HealthDay News) -- Acetaminophen, antiepileptics, antibiotics, and antituberculosis agents are the leading drug groups responsible for liver transplantation resulting from drug-induced acute liver failure (DIALF), according to research published in the July issue of Liver Transplantation.

Ayse L. Mindikoglu, M.D., of the University of Maryland School of Medicine in Baltimore, and colleagues conducted a retrospective cohort study of 661 patients who underwent liver transplantation for DIALF from 1987 through 2006. Data was collected from the United Network for Organ Sharing database.

The researchers found that the four leading drug groups responsible for DIALF-caused liver transplantation were acetaminophen (40 percent), antituberculosis agents (8 percent), antiepileptics (7 percent), and antibiotics (6 percent). The one-year estimated probability of survival associated with each of these groups was 76, 82, 52, and 82 percent, respectively. Low survival in the antiepileptic group was primarily observed in children, 73 percent of whom died within the first year. The authors further note that patients in the acetaminophen group were significantly more likely to require dialysis prior to liver transplant compared to all other drug groups (27 versus 3 to 10 percent).

The author of an accompanying editorial writes that the mathematical model used to predict survival after transplantation "falls short of immediate usefulness, but the identification of poorer outcome for children with antiepileptic DIALF is intriguing and points out the need for more focused research on drug-induced liver injury in pediatric populations."

One study author is an employee of Eli-Lilly and Company.

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