INDICATION FOR LIVER-TRANSPLANTATION IN S EVERE AMANITA-PHALLOIDES MUSHROOM POISONING

The clinical course of 12 patients with mushroom poisoning was evaluat ed in order to define the parameters considered to be relevant to the indication for liver transplantation. Eight patients recovered under c onservative therapy; one patient died due to pre-existing, concomitant cardiopulmonary disease. In three patients transplantations had to be performed because of severe liver failure. On admission, the transpla nted patients had a decreased Quick's test score and factor V value (< 10 %). The peak of liver enzymes, serum bilirubin, serum creatinine, partial thromboplastin time and azotemia were not of any prognostic va lue. Main indications for liver transplantation were a very low initia l Quick's test score and factor V value (both < 10 %) and their inadeq uate response under substitution therapy. The development of encephalo pathy and renal failure were further parameters indicating poor progno sis.