Philip Berry

Abstract

Acute liver failure (ALF) is a rare but frequently devastating condition, with the potential to disable virtually every organ and system in the body. However, if it is recognised swiftly, and if its specific complications are managed actively, a good outcome can be achieved, especially in the young. The first hours are crucial in stabilising the patient, optimising metabolic and cardiovascular parameters, and reducing the risk of permanent neurological injury or brain death. Simultaneous liason with a specialist unit will allow a planned, safe transfer and access to definitive treatment such as liver transplantation, should the patient require it.

This review highlights the clinical and laboratory features of ALF, emphasises aspects of early treatment which will aid short term survival, and makes recommendations concerning safe transfer to a liver unit. Information is also given to aid early counselling of relatives and next of kin.