Acetaminophen (Paracetamol) induced acute liver failure – A social problem in an era of increasing tendency to self-treatment
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Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland
Liver and Internal Medicine Unit of Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland
Centre of Postgraduate Medical Education, Warsaw Poland
Ministry of Health, Warsaw, Poland
Polish Transplant Coordinating Center “Poltransplant”, Warsaw, Poland
Department of Surgical and Transplant Nursing, Medical University of Warsaw, Poland
Department of Pathology, Medical University of Warsaw, Poland
Ann Agric Environ Med. 2015;22(4):762–767
The widespread availability of medication without prescription, so-called over the counter (OTC), and the rapid development of health consciousness of Poles is associated with broad access to medical information in the mass media. This causes patients to recognize their own disease, cancel doctor’s appointments, and begin self-treatment. This time and money-saving behavior, often signaled by pain, usually leads to the treatment of symptoms alone, without seeking the cause of the disease.The aim of the study was to present life-threatening paracetamol poisoning, and the treatment of acute liver failure.

Material and Methods:
In 2002–2014, 35 patients were hospitalized due to acute paracetamol poisoning: 17 female and 18 male patients aged between 17–59 (mean 32.3 years). Patients were treated in the surgical intensive care unit, where their parameters of liver and renal function were continuously monitored. If there was no improvement in the liver function, patients underwent albumin dialysis with the Prometheus system and were qualified for liver transplantation (LTx).

26 patients were treated pharmacologically and 7 out of 9 patients who underwent LTx were dialyzed. Overall, 11 patients had 26 albumin dialysis in total; 4 patients died – 1 post-transplant and 3 pre-transplant.

Paracetamol is the cause of many poisonings resulting from the lack of public awareness about toxic interactions with alcohol, and suicide attempts. Acetaminophen-induced acute liver failure concerns a small percentage of patients but can be successfully treated with albumin dialysis, and in extreme cases by liver transplantation.

Tadeusz Wróblewski   
Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland
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