An Overview On Acute Liver Failure; Prognosis and Treatment

Naser Ebrahimi-Daryani, Mohammad Taher, Samira Shirzad, MohammadReza Pashae


Acute liver failure (ALF) is an uncommon, devastating syndrome of which over 2000 cases occur annually in the USA, with a mortality rate of about 80%. ALF is de_ned by the sudden onset of hepatic encephalopathy and coagulopathy (INR_1.5) in an otherwise healthy person. The most common etiologies are acute viral hepatitis A and B, medication overdose (e.g., acetaminophen) and idiosyncratic drug reactions. The outcome of ALF is determined by its etiology, the degree of hepatic encephalopathy present on admission and by complications, particularly infection.

In the era of orthotopic liver transplantation and with improvements in the intensive care of patients with ALF, spontaneous recovery and overall survival now exceed 40% and 65%, respectively. Increased information about the etiologies and treatment options of this syndrome will improve the survival rate of our patients. In this study, we have decided to discuss the main issues of ALF by reviewing the literature and recent papers.


Acute liver failure; Acetaminophen toxicity; Liver transplantation; Hepatic assist systems.

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