1.0.0.0 Recommendations and GRADE
1.1.0.0 Recommendations
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Sr. no. |
Recommendations |
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1 |
In patients presenting with ALF, the AGA suggests against routinely testing all patients for Wilson’s disease Comment: In a setting of high clinical suspicion, testing for Wilson’s disease can be considered, keeping in mind the low positive predictive value Although the management and outcome of ALF would not be altered, identification of Wilson’s disease would allow appropriate post-transplantation management and screening of the patient’s family members |
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2 |
In patients presenting with ALF, the AGA suggests testing for HSV and treatment of patients with HSV |
Cond |
V Low |
|
3 |
In immunocompetent patients presenting with ALF, the AGA suggests against routinely testing all patients for VZV |
Cond |
V Low |
|
4 |
In pregnant women presenting with ALF, the AGA suggests testing for hepatitis E |
Cond |
V Low |
|
5 |
In patients presenting with ALF, the AGA suggests using the MELD score rather than the KCC as a prognostic scoring system. Comment: A MELD score of 30.5 (fixed cut-off level) should be used for prognosis; higher scores predict the need for liver transplantation |
Cond |
V Low |
|
6 |
In patients presenting with ALF, the AGA suggests against the routine use of liver biopsy |
Cond |
V Low |
|
7 |
In patients presenting with ALF, the AGA suggests autoantibody testing for autoimmune hepatitis be performed |
Cond |
V Low |
|
8 |
In patients presenting with ALF, the AGA suggests against the empiric use of treatments to reduce ICP. |
Cond |
V Low |
|
9 |
In patients presenting with ALF, the AGA recommends that extracorporeal artificial liver support systems only be used within the context of a clinical trial |
N/A |
N/A |
|
10 |
In patients presenting with acetaminophen-associated ALF, the AGA recommends the use of NAC in acetaminophen-associated ALF |
V Low |
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11 |
In patients presenting with non–acetaminophen-associated ALF, the AGA recommends that NAC only be used in the context of clinical trials |
N/A |
N/A |
SoR: Strength of Recommendation
QoE: Quality of Evidence
Strong: Strong Recommendation
Cond: Conditional Recommendation
High: High-Quality Evidence
Mod: Moderate-Quality Evidence
Low: Low-Quality Evidence
V Low: Very Low-Quality Evidence