Current concepts in acute liver failure

Ann Hepatol. 2019 Jul-Aug;18(4):543-552. doi: 10.1016/j.aohep.2019.04.008. Epub 2019 May 10.

Abstract

Acute liver failure (ALF) is a severe condition secondary to a myriad of causes associated with poor outcomes. The prompt diagnosis and identification of the aetiology allow the administration of specific treatments plus supportive strategies and to define the overall prognosis, the probability of developing complications and the need for liver transplantation. Pivotal issues are adequate monitoring and the institution of prophylactic strategies to reduce the risk of complications, such as progressive liver failure, cerebral oedema, renal failure, coagulopathies or infections. In this article, we review the main aspects of ALF, including the definition, diagnosis and complications. Also, we describe the standard-of-care strategies and recent advances in the treatment of ALF. Finally, we include our experience of care patients with ALF.

Keywords: Acute liver failure; Coagulation; Intracranial hypertension; Liver transplantation.

Publication types

  • Review

MeSH terms

  • Acetaminophen / poisoning
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Amanita
  • Analgesics, Non-Narcotic / poisoning
  • Biopsy
  • Blood Coagulation Disorders / blood
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / therapy
  • Brain Edema / prevention & control
  • Brain Edema / therapy
  • Chemical and Drug Induced Liver Injury / therapy*
  • Extracorporeal Circulation
  • Female
  • Hemorrhage / etiology
  • Hemorrhage / therapy
  • Hepatitis B / therapy
  • Hepatitis, Autoimmune / therapy
  • Humans
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / therapy
  • Liver / pathology
  • Liver Failure, Acute / complications
  • Liver Failure, Acute / pathology
  • Liver Failure, Acute / therapy*
  • Liver Transplantation
  • Mushroom Poisoning / therapy
  • Plasma Exchange
  • Pregnancy
  • Pregnancy Complications / therapy
  • Renal Replacement Therapy
  • Respiration, Artificial
  • Risk Assessment
  • Sepsis / etiology
  • Sepsis / therapy
  • Sorption Detoxification
  • Thrombelastography

Substances

  • Analgesics, Non-Narcotic
  • Acetaminophen