Acute liver failure (ALF) is a severe condition secondary to a myriad of causes associated with poor outcomes. The prompt diagnosis and identification of the aetiology allow the administration of specific treatments plus supportive strategies and to define the overall prognosis, the probability of developing complications and the need for liver transplantation. Pivotal issues are adequate monitoring and the institution of prophylactic strategies to reduce the risk of complications, such as progressive liver failure, cerebral oedema, renal failure, coagulopathies or infections. In this article, we review the main aspects of ALF, including the definition, diagnosis and complications. Also, we describe the standard-of-care strategies and recent advances in the treatment of ALF. Finally, we include our experience of care patients with ALF.
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http://dx.doi.org/10.1016/j.aohep.2019.04.008 | DOI Listing |
Metab Brain Dis
January 2025
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark.
Background & Aims: Hepatic encephalopathy (HE), one of the most serious prognostic factors for mortality in alcohol-related cirrhosis (ALD cirrhosis), is not recorded in Danish healthcare registries. However, treatment of HE with lactulose, the universal first-line treatment, can be identified through data on filled prescriptions. This study aimed to investigate if lactulose can be used as a surrogate marker of HE.
View Article and Find Full Text PDFUnited European Gastroenterol J
January 2025
Sheba Medical Center, Institute of Gastroenterology, Ramat-Gan, Israel.
Background: The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.
Methods: An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases.
Expert Rev Gastroenterol Hepatol
January 2025
Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi.
Introduction: Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity of bile acids. The spectrum is mostly structural, associated with reduced response to vasoconstrictors. The progression is rapid and need of renal replacement therapy and extracorporeal therapies may be required for the management.
View Article and Find Full Text PDFXenotransplantation
January 2025
Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Advancements in xenotransplantation intersecting with modern machine perfusion technology offer promising solutions to patients with liver failure providing a valuable bridge to transplantation and extending graft viability beyond current limitations. Patients facing acute or acute chronic liver failure, post-hepatectomy liver failure, or fulminant hepatic failure often require urgent liver transplants which are severely limited by organ shortage, emphasizing the importance of effective bridging approaches. Machine perfusion is now increasingly used to test and use genetically engineered porcine livers in translational studies, addressing the limitations and costs of non-human primate models.
View Article and Find Full Text PDFJ Coll Physicians Surg Pak
January 2025
Department of Anaesthesiology and Reanimation, Division of Intensive Care Medicine, Izmir Tepecik Training and Research Hospital, Izmir, Turkiye.
Objective: To evaluate the association of serum albumin levels with short-term mortality in ICU patients, including ICU and 28-day mortality.
Study Design: Observational study. Place and Duration of the Study: Intensive Care Unit, Izmir Tepecik Training and Research Hospital, Izmir, Turkiye, from January to July 2023.
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