Acute liver failure

R. Todd Stravitz, William M Lee

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Acute liver failure is a rare and severe consequence of abrupt hepatocyte injury, and can evolve over days or weeks to a lethal outcome. A variety of insults to liver cells result in a consistent pattern of rapid-onset elevation of aminotransferases, altered mentation, and disturbed coagulation. The absence of existing liver disease distinguishes acute liver failure from decompensated cirrhosis or acute-on-chronic liver failure. Causes of acute liver failure include paracetamol toxicity, hepatic ischaemia, viral and autoimmune hepatitis, and drug-induced liver injury from prescription drugs, and herbal and dietary supplements. Diagnosis requires careful review of medications taken, and serological testing for possible viral exposure. Because of its rarity, acute liver failure has not been studied in large, randomised trials, and most treatment recommendations represent expert opinion. Improvements in management have resulted in lower mortality, although liver transplantation, used in nearly 30% of patients with acute liver failure, still provides a life-saving alternative to medical management.

Original languageEnglish (US)
Pages (from-to)869-881
Number of pages13
JournalThe Lancet
Volume394
Issue number10201
DOIs
StatePublished - Sep 7 2019

Fingerprint

Acute Liver Failure
Chemical and Drug Induced Liver Injury
Autoimmune Hepatitis
Prescription Drugs
Liver
Expert Testimony
Acetaminophen
Dietary Supplements
Transaminases
Liver Transplantation
Liver Diseases
Hepatocytes
Fibrosis
Ischemia
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Acute liver failure. / Stravitz, R. Todd; Lee, William M.

In: The Lancet, Vol. 394, No. 10201, 07.09.2019, p. 869-881.

Research output: Contribution to journalReview article

Stravitz, RT & Lee, WM 2019, 'Acute liver failure', The Lancet, vol. 394, no. 10201, pp. 869-881. https://doi.org/10.1016/S0140-6736(19)31894-X
Stravitz, R. Todd ; Lee, William M. / Acute liver failure. In: The Lancet. 2019 ; Vol. 394, No. 10201. pp. 869-881.
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