Liver transplantation an effective treatment of acute liver failure caused by Amanita verna: Study

Amanita verna, commonly known as the fool's mushroom, destroying angel, mushroom fool or the spring destroying angel amanita, is a deadly poisonous basidiomycete fungus, one of many in the genus Amanita. Occurring in Europe in spring, Amanita verna is associated with various deciduous and coniferous trees. Amanita verna is one of the most harmful wild fungi in China. Amanita verna poisoning occurs every year, and the mortality is as high as 50%. However, its clinical manifestations are complex and diverse. Amanita phalloides, also known as 'death cap', is one of the most poisonous mushrooms, being involved in the majority of human fatal cases of mushroom poisoning worldwide.

In March 2019, three patients took a large amount of Amanita, and one of them received liver transplantation in Zhongshan hospital, Sun Yat-sen University. All patients had vomiting and diarrhoea 8–12 h after eating wild mushrooms (Amanita). The patients were initially diagnosed with Amanita poisoning. One case (case 3) was complicated and diagnosed as mushroom poisoning (fatal Amanita), toxic hepatitis, acute liver failure, toxic encephalopathy, hemorrhagic colitis, toxic myocarditis, disseminated intravascular coagulation (DIC) and pregnancy. The general clinical data of all patients were recorded, who received early treatment such as hemodialysis, artificial liver plasma exchange, hormone shock and anti-infection. One case (case 1) recovered smoothly after liver transplantation, and the indexes of liver, kidney, coagulation function and infection were improved. The other two cases died of intracerebral haemorrhage.

Thus, the researchers concluded that liver transplantation is an effective method for the treatment of acute liver failure caused by mushroom poisoning and can improve the survival rate of patients with toxic liver failure.

Reference:

Acute liver failure caused by Amanita verna: a case series and review of the literature by Jianlong Wu, et al. published in the BMC Surgery.

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-021-01434-6