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VOLUME 19 , ISSUE 1 ( 2015 ) > List of Articles

REVIEW ARTICLE

Recent advances in management of acute liver failure

Sunil Mathai, Charles Panackel, Rony Thomas, Benoy Sebastian

Keywords : fulminant liver failure, hepatocyte transplantation liver assist devices, liver transplantation, molecular adsorbents recirculation system,Acute liver failure

Citation Information : Mathai S, Panackel C, Thomas R, Sebastian B. Recent advances in management of acute liver failure. Indian J Crit Care Med 2015; 19 (1):27-33.

DOI: 10.4103/0972-5229.148636

License: CC BY-ND 3.0

Published Online: 00-01-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Acute 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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