Review article

https://doi.org/10.26800/LV-144-supl1-5

Acute liver failure and transplantation

Mirna Natalija Aničić ; Zavod za gastroenterologiju, hepatologiju i prehranu, Klinika za pedijatriju, KBC Zagreb, Medicinski fakultet Sveučilište u Zagrebu
Lana Omerza ; Zavod za gastroenterologiju, hepatologiju i prehranu, Klinika za pedijatriju, KBC Zagreb
Irena Senečić-Čala ; Zavod za gastroenterologiju, hepatologiju i prehranu, Klinika za pedijatriju, KBC Zagreb, Medicinski fakultet Sveučilište u Zagrebu
Duška Tješić-Drinković ; Zavod za gastroenterologiju, hepatologiju i prehranu, Klinika za pedijatriju, KBC Zagreb, Medicinski fakultet Sveučilište u Zagrebu
Jurica Vuković ; Zavod za gastroenterologiju, hepatologiju i prehranu, Klinika za pedijatriju, KBC Zagreb, Medicinski fakultet Sveučilište u Zagrebu

Abstract

Acute liver failure is a progressive clinical syndrome characterized by the rapid onset of liver dysfunction with consequent dysfunction of other organ systems. The diagnostic criteria differ from adults because the development of liver encephalopathy, especially in the early stages, is not easy to recognize, especially in newborns and infants, and it may not be present initially, so it is not necessary for diagnosis. The causes of acute liver failure are numerous and age dependent, and in almost 50% of cases despite exhaustive diagnostic testing the cause remains unknown. The clinical picture in children is often nonspecific (fatigue, myalgia, abdominal pain, nausea, and vomiting), and jaundice may or may not be present immediately. In the early stages of the disease, physical and neurological status can be completely normal, but knowing the unpredictability of this condition, which can result in multiorgan failure and coma in a few hours, it is crucial to transport the patient promptly to the transplant center. Patient care is led by a multidisciplinary team, and takes place in the Intensive care unit due to the possibility of continuous monitoring of vital functions and neurological status. Although a small proportion of patients achieve full recovery with symptomatic treatment, most still require a liver transplant. What is the
optimal time for a liver transplant and whether it is really needed or there is a possibility of spontaneous recovery, are eternal questions for the doctors who care for such patients. Until a good prognostic model for predicting survival with or without transplant is established, we are left with an individual assessment of each case.

Keywords

ACUTE LIVER FAILURE, CHILDREN, LIVER TRANSPLANT

Hrčak ID:

275638

URI

https://hrcak.srce.hr/275638

Publication date:

24.4.2022.

Article data in other languages: croatian

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