Logo

Acute liver failure

  1. Home
  2. Acute liver failure

Services

Image

Acute liver failure

Pediatric Acute Liver Failure (PALF) is a rapid loss of liver function in a previously healthy child, leading to coagulopathy, encephalopathy and multi-organ dysfunction. It requires urgent medical intervention and, in severe cases, liver transplantation.

KEY NOTE All acute liver failure patients do not need Liver Transplant. Some can be managed conservatively and medically. Contact with Dr Aniket Deshmukh, a dedicated paediatric hepatologist, offering expert care in ALF pateints.

Causes (Etiology)

  • Infections – Hepatitis A, B, C, E, CMV, EBV, HSV, COVID-19

  • Metabolic Disorders – Wilson's disease, mitochondrial disorders, galactosemia

  • Drugs & Toxins – Acetaminophen overdose, herbal toxins

  • Autoimmune Hepatitis – Immune-mediated liver injury

  • Ischemic/Hypoxic Injury – Shock, sepsis

  • Indeterminate Causes – ~50% of cases have no identifiable cause

Clinical Features

  • Jaundice & Severe Fatigue

  • Altered Mental Status (Hepatic Encephalopathy) – Confusion, irritability, coma

  • Coagulopathy (Bleeding Tendency) – Easy bruising, prolonged PT/INR

  • Ascites & Edema – Due to liver dysfunction

  • Hypoglycemia & Metabolic Imbalance – Due to liver's failure to maintain glucose levels

Complications

  • Cerebral Edema & Brain Herniation – Life-threatening in severe encephalopathy

  • Sepsis & Multi-Organ Failure – High risk of infections

  • Kidney Dysfunction – Hepatorenal syndrome

  • Respiratory Failure & Shock

Management

  • Supportive Care in ICU – Fluid balance, electrolytes, glucose infusion

  • Correction of Coagulopathy – Vitamin K, fresh frozen plasma (FFP)

  • Specific Treatments Based on Cause:

  • Acetaminophen toxicity – N-acetylcysteine (NAC)

  • Wilson's disease – Chelation therapy or urgent transplant

  • Liver Transplantation – For irreversible liver failure; Living donor or deceased donor transplant may be performed