Acute liver failure: A curable disease by 2024?

Summary Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver tra...

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Bibliographic Details
Published in:Journal of hepatology 2015-04, Vol.62 (1), p.S112-S120
Main Authors: Bernal, William, Lee, William M, Wendon, Julia, Larsen, Fin Stolze, Williams, Roger
Format: Article
Language:English
Subjects:
Acute liver failure
Ammonia
Blood-Brain Barrier
Brain Edema - etiology
Cerebral edema
Gastroenterology and Hepatology
Hepatic Encephalopathy - etiology
Humans
Liver Failure, Acute - etiology
Liver Failure, Acute - therapy
Liver Transplantation
Prognosis
Transplantation
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Summary:Summary Over the last three decades acute liver failure (ALF) has been transformed from a rare and poorly understood condition with a near universally fatal outcome, to one with a well characterized phenotype and disease course. Complex critical care protocols are now applied and emergency liver transplantation (ELT) is an established treatment option. These improvements in care are such that the majority of patients may now be expected to survive ( Fig. 1 ). Key features of the condition have changed dramatically over time, with a remarkable fall in the incidence of cerebral edema and intracranial hypertension, a much feared complication. In this review, we summarize the current understanding of key aspects of the classification, pathophysiology and management of ALF, and discuss the foreseeable challenges that will need to be addressed for further improvements to be achieved.
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2014.12.016