Abstract
Acute liver failure in children is a rare but potentially fatal disease. Causes of ALF in neonatal period are different from those in early or late childhood. Despite the improvement in the paediatric intensive care, liver transplantation remains the only effective treatment. Use of newer treatment modalities (liver assist devices and hepatocyte transplantation) is still in experimental phase. Management requires early recognition, prompt diagnosis of treatable condition, supportive therapy and prevention of complications hence these children should ideally be treated in a specialist unit.
Key words: Acute liver failure, Children, Liver transplantation
References
- 1.Bhaduri BR, Mieli-Vergani G. Fulminant hepatic failure pediatric aspects. Semin Liver Dis. 1996;16(4):349–355. doi: 10.1055/s-2007-1007248. [DOI] [PubMed] [Google Scholar]
- 2.Forbes A, Alexander GJ, O'Grady JG, Keays R, Gullan R, Dawling S, et al. Thiopental infusion in the treatment of intracranial hypertension complicating fulminant hepatic failure. Hepatology. 1989;10(3):306–310. doi: 10.1002/hep.1840100309. [DOI] [PubMed] [Google Scholar]
- 3.Ellis AJ, Wendon JA, Williams R. Subclinical seizure activity and prophylactic phenytoin infusion in acute liver failure: a controlled clinical trial. Hepatology. 2000;32(3):536–541. doi: 10.1053/jhep.2000.9775. [DOI] [PubMed] [Google Scholar]
- 4.Murphy N, Auzinger G, Bernel W, Wendon J. The effect of hypertonic sodium chloride on intracranial pressure in patients with acute liver failure. Hepatology. 2004;39(2):464–470. doi: 10.1002/hep.20056. [DOI] [PubMed] [Google Scholar]
- 5.Jalan R, Damink SW, Deutz NE, Lee A, Hayes PC. Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure. Lancet. 1992;354(9185):1164–118. doi: 10.1016/S0140-6736(98)12440-6. [DOI] [PubMed] [Google Scholar]
- 6.Ellis D, Avner ED, Starzl TE. Renal failure in children with hepatic failure undergoing liver transplantation. J Pediatr. 1986;108(3):393–398. doi: 10.1016/S0022-3476(86)80879-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Rolando N, Philpott-Howard J, Williams R. Bacterial and fungal infection in acute liver failure. Semin Liver Dis. 1996;16(4):389–402. doi: 10.1055/s-2007-1007252. [DOI] [PubMed] [Google Scholar]
- 8.Stange J, Hassanein TI, Mehta R, Mitzner SR, Bartlett RH. The molecular adsorbents recycling system as a liver support system based on albumin dialysis: a summary of preclinical investigations, prospective, randomized, controlled clinical trial, and clinical experience from 19 centers. Artif Organs. 2002;26(2):103–10. doi: 10.1046/j.1525-1594.2002.06822.x. [DOI] [PubMed] [Google Scholar]
- 9.Ellis AJ, Hughes RD, Wendon JA, Dunne J, Langley PG, Kelly JH, et al. Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure. Hepatology. 1996;24(6):1446–14451. doi: 10.1002/hep.510240625. [DOI] [PubMed] [Google Scholar]
- 10.Kjaergard LL, Liu J, Is-Nielsen B, Gluud C. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure: a systematic review. JAMA. 2003;8(2):289–289. doi: 10.1001/jama.289.2.217. [DOI] [PubMed] [Google Scholar]
- 11.O'Grady JG, Alexander GJ, Hayllar KM, Williams R. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. 1989;97(2):439–445. doi: 10.1016/0016-5085(89)90081-4. [DOI] [PubMed] [Google Scholar]
- 12.Girlanda R, Vilca-Melendez H, Srinivasan P, Muiesan P, O'Grady JG, Rela M, et al. Immunosuppression withdrawal after auxiliary liver transplantation for acute liver failure. Transplant Proc. 2005;37(4):1720–1721. doi: 10.1016/j.transproceed.2005.03.141. [DOI] [PubMed] [Google Scholar]