Acute Liver Failure - Review

Abstract

Acute liver failure (ALF) is defined as the development of impaired hepatic synthetic function with coagulopathy and
the development of hepatic encephalopathy in the absence of underlying liver disease in less than 2 to 3 month time.1
In
the setting of ALF, hepatic encephalopathy may be associated with life-threatening cerebral edema, whereas by contrast
this association is absent in patients who have chronic liver failure with encephalopathy. The recovery from the loss of
functional liver mass in acute liver injury occurs more readily than in the chronic setting because of the lack of longstanding fibrosis and portal hypertension, and the host’s overall better nutritional status. Therefore, if the individual can
be supported properly throughout the acute event, and the inciting injury is removed or ameliorated, recovery will follow the rapid regeneration of liver cells. For those in whom spontaneous recovery is not possible, liver transplant may
be life-saving. In this review, we outline the causes and clinical manifestations of acute liver failure and discuss current
approaches to patient care.