Diagnosis and Management of Acute Liver Failure

Anne M. Larson


Curr Opin Gastroenterol. 2010;26(3):214-221. 

In This Article

Abstract and Introduction


Purpose of review Acute liver failure (ALF) is a devastating syndrome afflicting previously healthy individuals. Early recognition of the illness is crucial, as aggressive treatment may improve outcomes. Despite significant advances in care, however, the mortality remains high (30–100%). This brief review will focus on the causes and overall management of the complications of ALF.
Recent findings Our knowledge of the causes of ALF has expanded significantly in the last decade. The mechanism of hepatic encephalopathy and cerebral edema in this setting continues to be elucidated and is discussed here.
Summary Improved outcomes can be achieved with the early recognition and aggressive management of ALF.


Acute liver failure (ALF) is a catastrophic multiorgan syndrome occurring in previously healthy individuals that is characterized by severe hepatocellular dysfunction and may swiftly progress to death. ALF affects about 2000–2800 persons annually (3.5 deaths per million population) and accounts for 5–6% of liver transplants in the United States.[1,2] The clinical syndrome is the same, regardless of the cause. Improved medical management and emergent orthotopic liver transplantation (OLT) have improved overall patient survival, yet mortality ranges from 30 to 100%. This review will briefly outline the causes, diagnosis, and up-to-date management of this devastating illness.