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Proceedings of ESPGHAN Monothematic Conference 2020: "Acute Liver Failure in Children": Diagnosis and Initial
Aglaia Zellos1, Dominique Debray2, Giuseppe Indolfi3
1First Department of Pediatrics, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Insights
This review updates physicians on recent advances in pediatric acute liver failure (ALF). It covers diagnosis, treatment, and intensive care, highlighting key learning points and future research needs in this critical condition.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Liver Disease
Background:
- Acute liver failure (ALF) is a severe condition in infants and children with high mortality.
- Many cases of pediatric ALF remain undiagnosed, necessitating improved recognition and management strategies.
Purpose of the Study:
- To update healthcare professionals on the latest research and developments in pediatric acute liver failure.
- To provide insights into early recognition, curative therapies, and intensive care management for ALF in pediatric populations.
Main Methods:
- The content is based on presentations from the 2020 ESPGHAN monothematic conference on pediatric hepatology, focusing on acute liver failure.
- Key learning points from expert oral presentations on ALF diagnosis and management were summarized.
Main Results:
- Discussions covered ALF definition, epidemiology, causes in neonates and older children, and recurrent ALF (RALF).
- New management aspects included hepatic encephalopathy, coagulopathy, intensive care, acute on chronic liver failure, and the role of imaging.
Conclusions:
- The report summarizes key takeaways from the conference on pediatric ALF.
- Identified knowledge gaps will guide the future research agenda in pediatric hepatology.
Objectives:
The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) aims to educate pediatric gastroenterologists, members of ESPGHAN and professionals from other specialties promoting an exchange of clinical expertise in the field of pediatric hepatology. Herewith we have concentrated on detailing the recent advances in acute liver failure in infants and children.
Methods:
The 2020 ESPGHAN monothematic three-day conference on pediatric hepatology disease, entitled "acute liver failure" (ALF), was organized in Athens, Greece. ALF is a devastating disease with high mortality and most cases remain undiagnosed. As knowledge in diagnosis and treatment of ALF in infants and children has increased in the past decades, the objective was to update physicians in the field with the latest research and developments in early recognition, curative therapies and intensive care management, imaging techniques and treatment paradigms in these age groups.
Results:
In the first session, the definition, epidemiology, various causes of ALF, in neonates and older children and recurrent ALF (RALF) were discussed. The second session was dedicated to new aspects of ALF management including hepatic encephalopathy (HE), coagulopathy, intensive care interventions, acute on chronic liver failure, and the role of imaging in treatment and prognosis. Oral presentations by experts in various fields are summarized highlighting key learning points.
Conclusions:
The current report summarizes the major learning points from this meeting. It also identifies areas where there is gap of knowledge, thereby identifying the research agenda for the near future.
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