Evidence map›Paper›PMID 40621689›Full record

ArticleJournal of pediatric gastroenterology and nutrition2025

Paediatric acute liver failure: A prospective, nationwide, population-based surveillance study in Germany.

Dominic Lenz, Muhammad Abdulaziz, Bianca Peters, Matias Wagner, Lea D Schlieben, Victor M Corman, Ulrich Baumann, Philip Bufler, Tal Dattner, Rainer Ganschow and 31 more

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In one paragraph

Article in Journal of pediatric gastroenterology and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Dominic LenzDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-9561-8190
Muhammad AbdulazizDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Bianca PetersDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Matias WagnerSchool of Medicine, Institute of Human Genetics, Technical University of Munich, Munich, Germany.
Lea D SchliebenSchool of Medicine, Institute of Human Genetics, Technical University of Munich, Munich, Germany.
Victor M CormanInstitute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Ulrich BaumannDepartment of Paediatric Kidney, Division for Paediatric Gastroenterology and Hepatology, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Philip BuflerDepartment of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin Berlin, Berlin, Germany.
Tal DattnerDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Rainer GanschowDepartment of Pediatrics, University Hospital Bonn, Bonn, Germany.
Kristin GenzelPediatrics, HELIOS Klinikum Erfurt, Erfurt, Germany.
Nicole HammannDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Steffen HartleifPaediatric Gastroenterology and Hepatology, University Children's Hospital, Eberhard Karls University Tubingen, Tubingen, Germany.
Bianca HegenDepartment of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Stephan HenningDepartment of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin Berlin, Berlin, Germany.
André HoerningDepartment of Pediatrics, University Hospital Erlangen, Friedrich Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
Martin JankofskyDepartment of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Norman JungeDepartment of Paediatric Kidney, Division for Paediatric Gastroenterology and Hepatology, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.
Simone KathemannDepartment of Pediatric Gastroenterology, Hepatology, and Transplant Medicine, Children's Hospital, University Duisburg-Essen, Essen, Germany.
Birgit KnoppkeKUNO University Children's Hospital, University Hospital Regensburg, Regensburg, Germany.
Martina Kohl-SobaniaDepartment of General Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany.
Martin LaassChildren's Hospital, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Elke LainkaDepartment of Pediatric Gastroenterology, Hepatology, and Transplant Medicine, Children's Hospital, University Duisburg-Essen, Essen, Germany.
Eberhard LurzDepartment of Pediatrics, Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
Michael MelterKUNO University Children's Hospital, University Hospital Regensburg, Regensburg, Germany.
Hanna MüllerDepartment of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Hospital Marburg Baldingerstraße, Marburg, Germany.
Denisa PilicDepartment of Pediatric Gastroenterology, Hepatology, and Transplant Medicine, Children's Hospital, University Duisburg-Essen, Essen, Germany.
Markus RiesDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Lisa SchiefeleDepartment of Pediatrics and Adolescent Medicine, Division of Neonatology and Pediatrics, University Medical Center Ulm, Ulm University, Ulm, Germany.
Tobias SchwerdDepartment of Pediatrics, Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
Ekkehard SturmPaediatric Gastroenterology and Hepatology, University Children's Hospital, Eberhard Karls University Tubingen, Tubingen, Germany.
Mechtild WegnerDepartment of Pediatrics, University Hospital Greifswald, Greifswald, Germany.
Michael S UrschitzGerman Paediatric Surveillance Unit (ESPED), Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
Sven F GarbadeDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Daniel WenningDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Christian DrostenInstitute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Alexander FichtnerDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Stefan KölkerDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Georg F HoffmannDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.
Holger ProkischSchool of Medicine, Institute of Human Genetics, Technical University of Munich, Munich, Germany.
Christian StaufnerDepartment I, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Division of Pediatric Neurology and Metabolic Medicine, Heidelberg University, Heidelberg, Germany.

Funding

BMBF (German Federal Ministry of Education and Research) through the mitoNET German Network for Mitochondrial Diseases 01GM1906BDietmar Hopp Foundation, St. Leon-Rot, Germany 23011235the Dietmar Hopp Foundation, St. Leon-Rot, Germany 23011235
6 · The paper itself

Abstract

objectivesPaediatric acute liver failure (PALF) is a rare but life-threatening condition, yet comprehensive epidemiological data in Germany are lacking. Our study aimed to systematically analyse incidence, aetiology, and outcome of PALF in Germany.

methodsIn a nationwide, population-based surveillance study, cases of PALF (defined following the PALF study group inclusion criteria) were queried from 2016 to 2018 through the German Paediatric Surveillance Unit (ESPED). Demographic, clinical, laboratory, therapeutic, and outcome data were collected and analysed. In case of unexplained aetiology, whole exome and virus sequencing was offered as a complementary diagnostic.

resultsOver the 3-year period, 148 cases were reported, yielding an estimated incidence of 3.7 per 1 million children per year. Neonates and infants were predominantly affected (45% of the cases); median age at PALF was 1.2 years (range: 0-17.9 years). Metabolic/genetic diseases were the most common cause (23%), followed by infectious causes (17%). The overall diagnostic yield was 73%, diagnosis remained unknown in 40 cases. Clinical outcome was age-dependent: new-borns showed a significant higher lethality (42%), followed by infants (29%), toddlers (15%), and school children (12%). Liver transplantation was reported in 22% of cases.

conclusionsThis study provides comprehensive insights into PALF epidemiology in Germany. Metabolic/genetic causes and infectious diseases were most common. Advances in standardised diagnostic work-up and genetic analysis have enhanced diagnostic yield, yet mortality remains substantial, particularly among neonates. Further research is warranted to improve diagnostic accuracy, therapeutic outcomes, and overall management of PALF.

Indexed as

Liver Failure, AcuteAdolescentChildChild, PreschoolFemaleGermanyHumansIncidenceInfantInfant, NewbornLiver TransplantationMalePopulation SurveillanceProspective StudiesaetiologyESPEDincidenceoutcomePALF

Identifiers

PMID40621689
PMCPMC12408955

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.