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.Drug-induced liver injury is a diagnosis of exclusion; a thorough history-taking and workup should be performed to rule out other possible etiologies Liver biopsy should be considered to help confirm the presence of drug-induced liver injury, if autoimmune hepatitis may be associated with the condition, and when immunosuppressive agents are being considered. 

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.

 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. Cerebral edema caused by acute liver failure can increase pressure on your brain. 

 Statistics

Liver disease is the only major cause of death still increasing year-on-year Liver disease is the fifth ‘big killer’ in England & Wales, after heart, cancer, stroke and respiratory disease 16,087 people in the UK died from liver disease in 20082, a 4.5% increase since 2007. This includes 13,805 people in England and Wales3, 1,903 in Scotland4 and 379 in Northern Ireland5 Twice as many people now die from liver disease as in 1991 Liver disease kills more people than diabetes and road deaths combined. These statistics are not comprehensive, due to two major reasons for under recording: the stigma associated with liver disease and attempts to avoid distress to the bereaved, and attribution of liver deaths to other codes as liver disease frequently causes multiple organ dysfunction. It is important to remember that as people can survive with 70% liver damage, there is a substantial burden of morbidity from liver disease, a high cost to the NHS and a huge economic and human cost from liver-related ill health.