Acute liver failure
From Wikipedia, the free encyclopedia
Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease (such as jaundice), and indicates that the liver has sustained severe damage (loss of function of 80-90% of liver cells). The complications are hepatic encephalopathy and impaired protein synthesis (as measured by the levels of serum albumin and the prothrombin time in the blood). The 1993 classification defines hyperacute as within 1 week, acute as 8-28 days and subacute as 4-12 weeks.[1]
Contents |
[edit] Causes
Common causes for acute liver failure are paracetamol (acetaminophen) overdose, idiosyncratic reaction to medication, viral hepatitis (hepatitis A or B - it is extremely uncommon in hepatitis C), and idiopathic (without an obvious cause).
[edit] Treatment
Treatment involves admission to hospital; often intensive care unit admission or very close observation are required. Supportive treatment is with adequate nutrition, optimalisation of the fluid balance, mechanical ventilation and intracranial pressure monitoring (in severe encephalopathy), and treatment aimed at removing the underlying cause (such as acetylcysteine for paracetamol poisoning). Other supportive measures may include the drainage of ascites.
While many people who develop acute liver failure recover with supportive treatment, liver transplantation is often required in people who continue to deteriorate or have adverse prognostic factors.
"Liver dialysis" (various measures to replace normal liver function) is evolving as a treatment modality and is gradually being introduced in the care of patients with liver failure.
[edit] References
- ^ O'Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993;342:273-5. PMID 8101303.
[edit] External links
- Acute Hepatic Failure - emedicine.com article.
- Fulminant Hepatic Failure - emedicine.com article.
