Acute liver failure; clinical features and management

Acute liver failure (ALF) is uncommon and may be associated with a high mor tality rate, Its aetiology shows considerable geographical variation, with viral hepatitis the most common worldwide, whilst acetaminophen (paracetamo l) induced hepatotoxicity forms the most common precipitant in many develop ed countries, Its management requires meticulous intensive care and the eff ective management of haemodynamic, septic and cerebral complications. The e arly identification of patients unlikely to survive without emergency liver transplantation is important to maximize the possibility of an available g raft. Survival in those patients who undergo transplantation may be in exce ss of 75%. Eur J Gastroenterol Hepatol 11:977-984 (C) 1999 Lippincott Willi ams & Wilkins.