Pediatric Acute Liver Failure: Current Perspectives

Abstract

It is well known that acute liver failure (ALF) in children is rare but potentially a 
life-threatening disorder. Its true incidence in the pediatric population is undetermined but is 
responsible for 10-15% of all pediatric liver transplantations.1
 Unlike adults, a specific cause 
of pediatric ALF is not identified in almost half of the cases,2
 and the etiology is classified as 
indeterminate in 18-47% of all patients.1
 The etiology is important because the survival rate and 
need for liver transplantation vary depending on the diagnosis. Spontaneous recovery is better 
in children with toxic etiology and worst for those with indeterminate or other causes.1,2 There 
is no specific treatment for most ALF cases, and the mainstay of medical care is to minimize 
complications and to limit additional morbidity.3
 ALF can be associated with rapidly progressive multiorgan failure and high mortality rates. One of the leading causes of death is cerebral 
edema and intracranial hypertension (ICH), responsible for about 20-25% of all deaths.3
 From 
that perspective, it is desirable to develop new therapies/technologies for diagnostic investigation and interventions.