[Acute liver failure--surgical approach]

Emergency liver transplantation is the only therapy of proven benefit for patients suffering from acute liver failure. The decision-making for transplantation mostly relies on clinical experience. The positive predictive value of prognostic scoring systems is reliable whereas the negative predictive value reaches only 60%. Due to a high postoperative mortality of 20-30%, the overall results after liver transplantation for acute liver failure are inferior to those obtained after transplantation for chronic liver diseases. The most important prognostic parameters are the severity of multi organ failures and the degree of encephalopathy prior to transplantation. However, long-term survival thereafter is mostly excellent.