医学资料-acute liver failure lancet.pdfVIP

Seminar Acute liver failure William Bernal, Georg Auzinger, Anil Dhawan, Julia Wendon Lancet 2010; 376: 190–201 Acute liver failure is a rare disorder with high mortality and resource cost. In the developing world, viral causes Liver Intensive Therapy Unit predominate, with hepatitis E infection recognised as a common cause in many countries. In the USA and much of (W Bernal MD, G Auzinger EDIC, western Europe, the incidence of virally induced disease has declined substantially in the past few years, with most J Wendon MD) , and cases now arising from drug-induced liver injury, often from paracetamol. However, a large proportion of cases are of Paediatric Liver Services (Prof A Dhawan MD), Institute unknown origin. Acute liver failure can be associated with rapidly progressive multiorgan failure and devastating of Liver Studies, King’s College complications; however, outcomes have been improved by use of emergency liver transplantation. An evidence base Hospital, London, UK for practice is emerging for supportive care, and a better understanding of the pathophysiology of the disorder, Correspondence to: especially in relation to hepatic encephalopathy, will probably soon lead to further improvements in survival rates. Dr William Bernal, Liver Intensive Therapy Unit, Institute of Liver Studies, King’s Introduction does not depend on this symptom but only on College Hospital, Denmark Hill, Acute liver failure is the clinical manifestation of coagulopathy due to liver injury. A designation accepted London SE5 9RS, UK sudden and severe hepatic injury and arises from many for clinical and research studies is t