• Indian J Crit Care Med · Jan 2015

    Review

    Recent advances in management of acute liver failure.

    • Charles Panackel, Rony Thomas, Benoy Sebastian, and Sunil K Mathai.
    • Department of Gastroenterology and Liver Transplantation, Medical Trust Hospital, Cochin, Ernakulam, Kerala, India.
    • Indian J Crit Care Med. 2015 Jan 1; 19 (1): 27-33.

    AbstractAcute liver failure (ALF) is a life-threatening illness, where a previously normal liver fails within days to weeks. Sudden loss of synthetic and detoxification function of liver results in jaundice, encephalopathy, coagulopathy, and multiorgan failure. The etiology of ALF varies demographically. The mortality of ALF is as high as 40-50%. The initial care of patients with ALF depends on prompt recognition of the condition and early detection of etiology. Management includes intensive care support, treatment of specific etiology if present and early detection of candidates for liver transplantation. Liver transplantation remains the only therapeutic intervention with proven survival benefit in patients with irreversible ALF. Living related liver transplantation, auxiliary liver transplantation, and  ABO-incompatible liver transplantation are coming up in a big way. Liver assist devices and hepatocyte transplant remain experimental and further advances are required. Public health measures to control hepatitis A, B, E, and drug-induced liver injury will reduce the incidence and mortality of ALF.

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