ALF is a life threatening condition due to sudden necrosis or death of liver cells due to various possible reasons.
Typically , these are often young patients with no earlier history of liver disease. They present with Jaundice ( yellowing of eyes ) and after a few days they suddenly become sleepy or confused or disoriented and sometimes comatose. This is accompanied by a rise in the Prothrombin Time or INR – an important blood parameter. This is the classic clinical presentation of ALF.
While sometimes the cause of ALF is never known ( 15 – 20% ), a larger proportion may be caused by :
- Viral hepatitis
- Drugs & toxins
- Wilson’s disease
- Paracetamol poisoning
ALF has a dramatic clinical course – if the blood tests meets certain criteria, the chances of improvement are less than 20%
then, urgent liver transplant is the only hope of cure in such situations.
Liver transplantation has now become a well accepted treatment for patients with ALF.
The King’s College Hospital (KCH) criteria have been extensively used for selecting patients for emergency liver transplantation. Survival rates after liver transplantation approach 80% for ALF.
The clinical condition for a patient with ALF can change significantly within a short period of time. Therefore, early referral, rapid donor work up and prompt decision by the family for transplantation are the keys to be able to salvage a patient with liver transplantation