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Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
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Specific Therapies For ALF: Viral, Autoimmune and Wilson Disease
Margherita Saracco1, Silvia Strona1, Chiara Manuli1
1SSD Insufficienza Epatica e Trapianto Epatico, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
Journal of Intensive Care Medicine
|April 15, 2026
Summary
Targeted treatments for acute liver failure (ALF) from autoimmune hepatitis, viral infections, and Wilson's disease are reviewed. Early prognostic assessment and timely interventions like antivirals or liver transplantation (LT) are crucial for survival.
Area of Science:
- Hepatology
- Internal Medicine
- Virology
Background:
- Acute liver failure (ALF) presents a critical medical challenge with diverse etiologies.
- Autoimmune hepatitis, viral infections, and Wilson's disease are significant causes of ALF requiring specific management strategies.
- Effective prognostic assessment is vital for guiding therapeutic decisions and liver transplantation (LT) evaluation.
Purpose of the Study:
- To provide an updated overview of targeted treatments for ALF.
- To emphasize prognostic assessment and therapeutic decision-making in ALF management.
- To review treatment strategies for ALF caused by autoimmune hepatitis, viral infections, and Wilson's disease.
Main Methods:
- A structured literature search was conducted in PubMed/MEDLINE and Embase.
- Studies published between January 2000 and December 2025 were included.
- Original articles, meta-analyses, and clinical guidelines relevant to ALF treatment were selected.
Main Results:
- Corticosteroids are first-line for autoimmune hepatitis ALF, with prognostic models aiding non-responder identification for timely LT.
- Nucleos(t)ide analogues improve survival in hepatitis B-related ALF; empirical antivirals are critical for non-hepatotropic viral causes.
- Early recognition and transplant referral are essential for Wilson's disease-related ALF; therapeutic plasma exchange may offer temporary support.
Conclusions:
- Timely and accurate prognostic assessment is paramount in managing ALF.
- Etiology-specific treatments, including antivirals and immunosuppressants, are crucial but often lose effectiveness with advanced encephalopathy.
- Emergency liver transplantation remains the definitive treatment for ALF when medical therapies fail or are insufficient.
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