Liver failure

Current Opinion in Anaesthesiology
Michael BauerAndreas Kortgen

Abstract

Liver failure is a rare but life-threatening condition affecting a multitude of other organ systems, most notably the brain and kidneys, following severe hepatocellular injury. Liver failure may develop in the absence ('acute') or presence ('acute-on-chronic') of liver disease with substantial differences in pathophysiology and therapeutic options. Within the last 12 months substantial progress has been made in identifying patients who will potentially benefit from extracorporeal support of their failing liver. In addition to traditional 'static' laboratory tests to assess liver function, the significance of 'dynamic' tests, such as indocyanine green clearance, has been better defined, and these tests are becoming more easily available. Transplantation remains the treatment of choice for fulminant, acute and subacute liver failure with predicted unfavorable outcome according to King's College or Clichy criteria, most notably in the absence of pre-existing liver disease, and should be performed before extrahepatic complications emerge. Encouraging results have been obtained with the use of support systems in patients with acute and acute-on-chronic liver failure in relatively small patient collectives, making well-conducted rand...Continue Reading

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Citations

Oct 7, 2006·Cost Effectiveness and Resource Allocation : C/E·Franz P Hessel
Mar 10, 2009·Liver International : Official Journal of the International Association for the Study of the Liver·Yellapu Radha KrishnaGour Choudhuri
Nov 22, 2014·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Xiang-Fen JiKai Wang
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Feb 18, 2010·Current Opinion in Critical Care·Josef A VogtMichael Georgieff
Jul 12, 2011·Virchows Archiv : an International Journal of Pathology·Archana RastogiShiv Kumar Sarin

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