acute liver failure

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Acute hepatic failure occurs when there is a massive loss of hepatocytes. It is defined as severe hepatic dysfunction occuring within 6 months of the onset of symptoms of liver disease, with a clinical manifestation of hepatic encephalopathy or coagulopathy.

It is further subdivided to describe fulminant liver failure - symptoms occuring in eight weeks, and subacute, subfulminant or late onset liver failure occuring in the rest of the 6 month period.

A new terminology however has been suggested to acknowledge the clinical finding that patients with a more rapid onset of hepatic failure are more likely to recover. This classification is as follows: hyperacute - encephalopathy within seven days of the onset of jaundice, acute - encephalopathy after 8-28 days of jaundice and subacute - when encephalopathy occurs 5-12 weeks after the onset of jaundice.

The subclassification of acute liver failure is not internationally standardised. Earlier discrimination of patients is of most use when considering those most appropriate for transplantation.

Last reviewed 01/2018