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Acute Liver Failure in Adults

Sanjiv chopra, MBBS. MACP and Hirsh D. Trivedi, MD Reviewed 06/2022
 


BASICS

  • Acute liver failure (ALF), previously referred to as "fulminant hepatic failure" is a rare, but life-threatening illness that most often occurs in individuals without preexisting liver disease ...

DIAGNOSIS

ALF is a clinical diagnosis that includes: 
  • Acute altered mental status, i.e., hepatic encephalopathy

  • Profound coagulopathy (usually an international normalized ratio [INR] above 1.5-2.0)

  • No pr...

TREATMENT

The timing of onset (hyperacute, acute, subacute) and etiology of ALF guide management. 

GENERAL MEASURES

  • Critical care and supportive measures are the cornerstone of therapy (1)[A]. All pati...

ONGOING CARE

King's College criteria for liver transplantation include : 
  • Age

  • Cause of ALF

  • Presence of encephalopathy

  • Bilirubin levels

  • Coagulopathy

  • Presence of acidosis and renal failure

FOLLOW-UP RECOMMENDATIONS

REFERENCES

1
Bernal W, Wendon J. Acute Liver Failure. N Engl J Med. 2013;369:2525-34.

ADDITIONAL READING

CLINICAL PEARLS

  • Acute liver failure is a rare, but life-threatening event.

  • The most common causes in developing nations relate to viral infections; drug-induced liver injury is most common in developed...

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