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Diagnostic Approach to Acute Liver Failure in Children: A Position Paper by the SIGENP Liver Disease Working Group

A Di Giorgio1, E Bartolini2, P L Calvo3

  • 1Paediatric Liver, GI and Transplantation, ASST-Hospital Papa Giovanni XXIII, Piazza OMS1, Bergamo 24127, Italy.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|March 29, 2021
PubMed

Insights

Acute liver failure (ALF) is a serious condition in children. This review provides guidance on diagnosing and understanding the causes of pediatric ALF, crucial for effective management.

Area of Science:

  • Pediatric Hepatology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Acute liver failure (ALF) is a rapid decline in liver function.
  • Pediatric ALF presents with coagulopathy and elevated transaminases, without prior chronic liver disease.
  • ALF has a high mortality rate, often necessitating liver transplantation.

Purpose of the Study:

  • To review current literature on pediatric ALF.
  • To provide recommendations on the etiology, clinical features, and diagnostic work-up of ALF in children.
  • To establish a foundation for future discussions on management and transplant candidacy.

Main Methods:

  • Systematic review of relevant studies on pediatric ALF.
  • Position statement developed by the Liver Disease Working Group of SIGENP.
  • Focus on neonates, infants, and children presenting with ALF.

Main Results:

  • Etiology of ALF varies significantly by age and region.
  • Identifying the cause of ALF is critical for targeted treatment and transplant evaluation.
  • Hepatic encephalopathy is not a prerequisite for diagnosing ALF in children.

Conclusions:

  • Accurate diagnosis and etiological identification are paramount in pediatric ALF.
  • This review offers essential guidance for clinicians managing pediatric ALF.
  • Further consensus will address medical management and liver transplant considerations.

Keywords:
ChildrenCoagulopathyFulminant hepatitisInfantsLiver transplantationNeonates

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