Acute Hepatic Failure

  • Andrew Slack
  • Brian J. Hogan
  • Julia Wendon


Acute liver failure (ALF) is an unpredictable and rapidly progressive, life-threatening multisystem condition that ensues when an insult causes diffuse necrosis of liver parenchyma disrupting hepatocyte function in patients who have no pre-existing liver injury. The subsequent development of encephalopathy and coagulopathy within days or weeks represents the key features of ALF, but critically often culminates with multi-organ failure (MOF), which impacts significantly on mortality. Timely referral to specialist centers with expertise in the management of ALF and liver transplantation (LT) is crucial.

ALF is rare with around 2800 and 400 cases of ALF per year in the United Stated (US) and the United Kingdom (UK), respectively [ 1]. There are multiple etiologies of ALF that vary with worldwide geographical location, clinical presentation, time course, and prognosis. In the developing world the leading cause of ALF are the viral hepatitides, particularly Hepatitis B. In the...


Acute hepatic failure Intracranial hypertension Epidemiology Paracetamol King’s College Criteria Plasma exchange 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Critical CareGuy’s and St Thomas’s NHS Foundation TrustLondonUK
  2. 2.Institute of Liver StudiesKings College London, Kings College HospitalLondonUK

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