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Acute Liver Failure

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  • Acute liver failure

     Acute liver failure (ALF) is a rare syndrome defined by a rapid decline in hepatic function characterised by jaundice, coagulopathy (INR >1.5), and hepatic encephalopathy in patients with no evidence of prior liver disease.The interval from the onset of jaundice to the development of encephalopathy occurs within 24 to 26 weeks and may further classify ALF into categories based on hyperacute, acute, or subacute presentations.Although clinical jaundice is considered a defining feature of ALF, it may not always be present, particularly in hyperacute presentations. 

    Typical symptoms

    Yellowing of your skin and eyeballs (jaundice) Pain in your upper right abdomen, Abdominal swelling, Nausea, Vomiting, A general sense of feeling unwell (malaise), Disorientation or confusion, Sleepiness.

  • Acute liver failure

     Therapeutic aspects

    Treatments for acute liver failure Acute liver failure treatments may include: Medications to reverse poisoning. Acute liver failure caused by acetaminophen overdose or mushroom poisoning is treated with drugs that can reverse the effects of the toxin and may reduce liver damage. Liver transplant. When acute liver failure can't be reversed, the only treatment may be a liver transplant. During a liver transplant, a surgeon removes your damaged liver and replaces it with a healthy liver from a donor. Treatments for complications Control signs and symptoms you're experiencing and try to prevent complications caused by acute liver failure. This care may include: Relieving pressure caused by excess fluid in the brain. 

     

  • Acute liver failure

     Statistics

    The majority of acute hepatitis A infections do not result in ALF, and many young patients with acute hepatitis A are anicteric and asymptomatic. Model for End-Stage Liver Disease (MELD) score ? 29 and an encephalopathy grade ? 3. In a direct comparison using a receiving operating characteristic curve analysis, the MELD score [C statistic = 0.830, 95% confidence interval (CI) = 0.73-0.93] had better prognostic accuracy for predicting outcomes than the Clichy criteria (C statistic = 0.719, 95% CI = 0.58-0.85) or the King's College criteria (C statistic = 0.631, 95% CI = 0.49-0.77). In conclusion, hepatitis B and AIH were the most frequent causes of fulminant hepatic failure in our series, and no cases of ACM overdosing were identified. A MELD score ? 29 and an encephalopathy grade ? 3 at admission were associated with death. The MELD score at admission showed the highest prognostic accuracy.

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