Acute liver failure: updates in pathogenesis and management

Acute liver failure is a life-threatening illness precipitated by an acute liver injury in patients with no pre-existing liver disease. Acute viral hepatitis and drug-induced liver injury account for most cases, the clinical course characterized by the development of coagulopathy and hepatic encephalopathy, often progressing to multi-organ disease, which is associated with high fatality rates. The outcomes have improved significantly over time with improving standards of organ system support and access to liver transplantation for very sick individuals. The King's College criteria are the most commonly used tool for determination of prognosis and consideration for transplantation. Prompt diagnosis, immediate initiation of supportive care and aetiology-specific treatment, where applicable, as well as early discussions and transfer to a transplant centre, are the keys to successful outcome