Liver Transplantation for Acute Toxic Hepatitis due to Herbal Medicines and Preparations.
- Author:
Chang Hwan SOHN
1
;
Myung Il CHA
;
Bum Jin OH
;
Woon Hyung YEO
;
Jae Ho LEE
;
Won KIM
;
Kyoung Soo LIM
Author Information
1. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. bjoh@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Acute toxic hepatitis;
Acute liver failure;
Herbal medicines and preparations
- MeSH:
Eleutherococcus;
Artemisia;
Capillaries;
Cucurbita;
Dictamnus;
Drug-Induced Liver Injury;
Humans;
Liver;
Liver Failure, Acute;
Liver Function Tests;
Liver Transplantation;
Medical Records;
Plant Preparations;
Polygonum;
Retrospective Studies;
Transplants
- From:Journal of The Korean Society of Clinical Toxicology
2008;6(2):110-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. METHODS: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. RESULTS: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. CONCLUSION: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.
