The Indian Journal of Pediatrics

, Volume 70, Issue 1, pp 73–79 | Cite as

Acute liver failure

Symposium on Advances in Pediatrics-I


Acute liver failure in children is associated with a high mortality. Most cases in our setup are due to water borne hepatotropic viruses HAV and HEV. The clinician must be aware of the earliest and the subtle signs of acute liver failure to identify cases early enough and institute supportive therapy. Focus of therapy has to be on prevention, early recognition and appropriate management of complications. Despite good intensive care, about 40–60% children with liver failure die. As and when liver transplantation becomes available in India, it would be an attractive option

Key words

Acute liver failure Etiology Management 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fagan EA, Williams R. Fulminant viral hepatitis. (Review)Br Med Bull 1990; 46:462–480.PubMedGoogle Scholar
  2. 2.
    Gust ID. The epidemiology of viral hepatitis. In Vyas GN, Dienstag JL, Hoomagle JH eds,Viral Hepatitis and Liver Disease. Orlando: Grune & Stratton, 1984; 415–421.Google Scholar
  3. 3.
    Akriviadis EA, Redeker AG. Fulminant hepatitis A in intravenous drug users with chronic liver disease.Ann Intern Med 1989; 110:838–839.PubMedGoogle Scholar
  4. 4.
    Gimson AE, White YS, Eddleston ALet al. Clinical and prognostic differences in fulminant hepatitis type A, B and non-A non-B.Gut 1983; 249:1194–1198.CrossRefGoogle Scholar
  5. 5.
    O’Grady JG, Alexander GJM, Hayllar KMet al. Early indicators of prognosis in fulminant hepatic failure.Gastroenterol 1989; 97:439 —445.Google Scholar
  6. 6.
    Treem WR. Hepatic failure In Walker WA, Durie PR, Hamilton JR, Walker Smith JA, Watkins JB ed,Pediatric Gastrointestinal Disease. BC Decker Inc, Philadelphia, 1991; 146–192.Google Scholar
  7. 7.
    Maggiore G, Hadchouel M, Sessa F, Vinci Met al. A retrospective study of the role of delta agent infection in children with HBsAg positive chronic hepatitis.Hepatology 1985; 5: 7–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Arora NK, Nanda SK, Gultati Set al. Acute viral hepatitis types E, A, and B singly and combination in acute liver failure in children in North India.J Med Virol 1996; 48: 215–221.PubMedCrossRefGoogle Scholar
  9. 9.
    Bendre SV, Bavdekar AR, Bhave SA, Pandit AN, Chitambar SD, Arankale VA. Fulminant hepatic failure. Etiology, viral marker and outcome.Ind Pediatr 1999; 36:1107–1112.Google Scholar
  10. 10.
    Poddar V, Thapa BR, Prasad A, Sharma AK, Singh K. Natural History and risk factor in fulminant hepatic failure.Arch Dis Child 2002; 87:54–56.PubMedCrossRefGoogle Scholar
  11. 11.
    Ede RJ, Gimson AES, Bihari Det al. Controlled hyperventilation in the prevention of cerebral edema in fulminant hepatic failure.J Hepatol 1986; 2:43–51.PubMedCrossRefGoogle Scholar
  12. 12.
    Caranci P, Van Thiel DH. Acute liver failure.Lancet 1995; 345: 163–169.CrossRefGoogle Scholar
  13. 13.
    Keays R, Harrison PM, Wendon JAet al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: A prospective randomized controlled trial.Br Med J 1991; 303:1026–1029.CrossRefGoogle Scholar
  14. 14.
    Ede RJ, Gimson AES, Bihari Det al. Controlled hyperventilation in the prevention of cerebral edema in fulminant hepatic failure.J Hepatol 1986; 2:43–51.PubMedCrossRefGoogle Scholar
  15. 15.
    Hanid MA, Davies M, Mellon PJet al. Clinical monitoring of intracranial pressure in fulminant hepatic failure.Gut 1980: 820–825.Google Scholar
  16. 16.
    Canalese J, Gimson AES, Davis C, Mellon PJ, Davis M, Williams R. Controlled trial of dexamethasone and mannitol for the cerebral edema of fulminant hepatic failure.Gut 1982; 23: 625–629.PubMedCrossRefGoogle Scholar
  17. 17.
    Wolpert E, Phillips SF, Summerskill WH. Ammonia production in human colon: effect of cleansing, neomycin and acetohydroxamic acid.N Eng J Med 1970; 283:159–164.CrossRefGoogle Scholar
  18. 18.
    Vince A, Bown R, O’Gady Fet al. The effect of perfusion on the flora of the excluded colon.Gut 1973; 14:178–182.PubMedCrossRefGoogle Scholar
  19. 19.
    Golper TA. continuous arteriovenous hemofiltration in acute renal failure.Am J Kidney Dis 1985; 6:373–386PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2003

Authors and Affiliations

  1. 1.Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations