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Education in practice
How to manage: acute liver failure
  1. Oliver D Tavabie,
  2. William Bernal
  1. Institute of Liver Studies, Kings College Hospital, London, UK
  1. Correspondence to Dr William Bernal, Institute of Liver Studies, Kings College Hospital, London SE5 9RS, UK; william.bernal{at}


Acute liver failure (ALF) is a rare but life-threatening clinical syndrome with a broad range of causes. Significant improvements in outcome have occurred over the last 50 years, resulting not only from incremental improvements in specialist critical care and a step-change following the introduction of transplantation for this indication, but also better and more effective treatment started early at the site of first presentation.1 2 Emergency liver transplantation (LTx) remains an important intervention and the decision regarding the need for LTx remains key to management, though non-transplant therapies now appear effective for many causes of the condition. In this short review, we will outline issues in the recognition and management of ALF and ongoing challenges in its treatment.

  • acute liver failure
  • liver transplantation
  • encephalopathy

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  • Correction notice This article has been corrected since it published Online First. The fifth heading under General Management has been corrected.

  • Contributors ODT conceived the review and wrote the first draft. WB revised and amended prior to submission and acts as a guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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