Acute liver failure: Early referral is the key

Lorenzo Rossaro, William Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Acute liver failure (ALF) is a rare but devastating condition which requires immediate recognition and management in experienced centers. The etiology of this syndrome is most frequently drug toxicity, with acetaminophen on top of the list, and acute viral hepatitis declining over the years. This condition is rapid and unpredictable, and the outcome is related to the etiology (acetaminophen and Hepatitis A, better than other drugs and Hepatitis B, and Wilson's disease the worst) and the degree of liver damage and hepatic encephalopathy at the time of presentation. Management includes supportive care in intensive care units, and specific treatments in certain conditions, such as delivery for acute fatty liver of pregnancy, N-Acetylcysteine for acetaminophen overdose, and silibinin for mushroom poisoning, among others. Liver transplantation is the standard of care for patients with a low chance of spontaneous survival. Bridging techniques with liver support devices are still experimental and none have proven benefit to date. A randomized controlled trial of N-Acetylcysteine for non-acetaminophen ALFs is underway. Early referral to experienced centers, and centers where liver transplant is available, is the key to improve outcome.

Original languageEnglish (US)
Pages (from-to)15-42
Number of pages28
JournalPractical Gastroenterology
Volume28
Issue number4
StatePublished - Apr 2004

Fingerprint

Acute Liver Failure
Acetaminophen
Referral and Consultation
Acetylcysteine
Liver
Mushroom Poisoning
Hepatolenticular Degeneration
Hepatitis A
Hepatic Encephalopathy
Standard of Care
Drug-Related Side Effects and Adverse Reactions
Hepatitis B
Liver Transplantation
Hepatitis
Intensive Care Units
Randomized Controlled Trials
Transplants
Equipment and Supplies
Survival
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Acute liver failure : Early referral is the key. / Rossaro, Lorenzo; Lee, William.

In: Practical Gastroenterology, Vol. 28, No. 4, 04.2004, p. 15-42.

Research output: Contribution to journalArticle

Rossaro, Lorenzo ; Lee, William. / Acute liver failure : Early referral is the key. In: Practical Gastroenterology. 2004 ; Vol. 28, No. 4. pp. 15-42.
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