MANAGEMENT OF ACUTE LIVER-FAILURE IN CHIL DREN

Among the main causes of acute liver failure (ALF) in children, metabo lic diseases (especially in infants), viral and toxin or drug induced hepatitis are the most frequent. The cause remains, however, undetermi ned in about 30% of the cases. Management must be conducted in a pedia tric hepatology unit or intensive care unit in relation with a pediatr ic transplant team in order: 1) to perform urgent etological diagnosis ; 2) to initiate specific therapy and symptomatic treatment; 3) to eva luate to severity and prognosis of liver disease for selection of chil dren for emergency liver transplantation; 4) to evaluate contraindicat ions to liver transplantation. The overall survival of post-emergency liver transplantation for ALF in children averages 65%.