Abstract: | Acute liver failure (ALF) is a rare but life-threatening disease with varying aetiologies worldwide. Drug-induced liver injury, including paracetamol poisoning, is the main cause in Europe and the USA. Whereas in the developing world, viral hepatitis is most common. ALF is a multisystem illness that leads to development of hepatic encephalopathy, cerebral oedema, vasodilatory shock, coagulopathy, hypoglycaemia and multiple-organ failure. Early referral to a specialist liver unit is essential. The core principles of ALF management are to identify/treat the underlying cause, provide supportive care and treat any complications. Optimal management will allow time for spontaneous liver regeneration or liver transplantation, and result in improved survival rates. This article provides an overview of the key concepts in ALF diagnosis and management. |