Acute liver failure surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Surgery

• Drainage of ascites
• While many people who develop acute liver failure recover with supportive treatment, liver transplantation is often required in people who continue to deteriorate or have adverse prognostic factors.
• "Liver dialysis" (various measures to replace normal liver function) is evolving as a treatment modality and is gradually being introduced in the care of patients with liver failure.

Liver Transplantation

King's College Hospital criteria for liver transplantation in acute liver failure

Patients with paracetamol toxicity pH <7.3 or Prothrombin time >100 seconds and serum creatinine level >3.4 mg/dL (>300 μmol/l) if in grade III or IV encephalopathy

Other patients Prothrombin time >100 seconds or Three of the following variables: Age <10 yr or >40 yr Cause: non-A, non-B hepatitis halothane hepatitis idiosyncratic drug reaction Duration of jaundice before encephalopathy >7 days prothrombin time >50 seconds Serum bilirubin level >17.6 mg/dL (>300 μmol/l)