[Acute liver failure. Diagnosis and therapy]

Area of Science:

• Hepatology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Acute liver failure (ALF) is a rare condition with a high mortality rate of 34%.
• Common causes in Western countries include acetaminophen overdose and viral hepatitis.
• ALF leads to loss of liver function, risking hepatic encephalopathy and multiorgan failure.

Purpose of the Study:

• To highlight the challenges in managing severe acute liver failure.
• To emphasize the critical role of liver transplantation.
• To introduce prognostic tools for improved patient selection.

Main Methods:

• Review of current understanding of acute liver failure.
• Discussion of existing therapeutic interventions.
• Introduction of prognostic scoring systems, such as the Acute Liver Failure Study Group score.

Main Results:

• Standard therapies like N-acetylcysteine or nucleotide analogs are often insufficient.
• Orthotopic liver transplantation remains the primary effective treatment for severe ALF.
• Prognostic tools are essential for optimizing the selection of transplant candidates.

Conclusions:

• Effective management of acute liver failure necessitates careful patient stratification.
• The development and application of prognostic scores are crucial given organ donor limitations.
• Improving patient selection for liver transplantation is vital for improving outcomes in ALF.