Acute liver failure; clinical features and management

Eur J Gastroenterol Hepatol. 1999 Sep;11(9):977-84. doi: 10.1097/00042737-199909000-00005.


Acute liver failure (ALF) is uncommon and may be associated with a high mortality rate. Its aetiology shows considerable geographical variation, with viral hepatitis the most common worldwide, whilst acetaminophen (paracetamol) induced hepatotoxicity forms the most common precipitant in many developed countries. Its management requires meticulous intensive care and the effective management of haemodynamic, septic and cerebral complications. The early identification of patients unlikely to survive without emergency liver transplantation is important to maximize the possibility of an available graft. Survival in those patients who undergo transplantation may be in excess of 75%.

Publication types

  • Review

MeSH terms

  • Acetaminophen / adverse effects*
  • Brain Edema / etiology*
  • Brain Edema / therapy
  • Diuretics, Osmotic / therapeutic use
  • Hepatitis, Viral, Human / complications*
  • Humans
  • Liver Failure, Acute* / etiology
  • Liver Failure, Acute* / mortality
  • Liver Failure, Acute* / therapy
  • Liver Transplantation
  • Mannitol / therapeutic use
  • Renal Insufficiency / etiology
  • Renal Insufficiency / therapy
  • Renal Replacement Therapy
  • Survival Analysis


  • Diuretics, Osmotic
  • Acetaminophen
  • Mannitol