[Acute liver failure]

Acute liver failure refers to the rapid development of severe acute liver injury with impaired synthetic function in a patient who previously had a normal liver or a well compensated liver disease. Its aetiology is diversified and it provides one of the best indicators of prognosis thus being crucial its quick identification. Because it can progress to multiple organ failure syndrome these patients should be managed in an Intensive Care Unit. The first therapeutic approach consists of intensive care support until treatment for specific aetiologies can be started. Besides encephalopathy, many other complications can develop causing the high rates of morbidity and mortality of acute liver failure and so they need tight surveillance and treatment. Liver support systems are therapeutic options still in study and without proven success in a long term period which makes hepatic transplantation the final therapeutic. Given the wide limitations of hepatic transplantation the final decision is based on a correct diagnosis and prognostic scoring systems.