Acute Liver Failure (Fulminant Hepatic Failure)

A form of rapid-onset LIVER FAILURE, also known as fulminant hepatic failure, caused by severe liver injury or massive loss of HEPATOCYTES. It is characterized by sudden development of liver dysfunction and JAUNDICE. Acute liver failure may progress to exhibit cerebral dysfunction even HEPATIC COMA depending on the etiology that includes hepatic ISCHEMIA, drug toxicity, malignant infiltration, and viral hepatitis such as post-transfusion HEPATITIS B and HEPATITIS C.

Also Known As:

Networked: 7208 relevant articles (447 outcomes, 693 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	End Stage Liver Disease
2.	Liver Diseases (Liver Disease)
3.	Fibrosis (Cirrhosis)
4.	Hepatic Encephalopathy
5.	Neoplasms (Cancer)

Experts

1.	Lee, William M: 93 articles (01/2022 - 11/2002)
2.	Jaeschke, Hartmut: 57 articles (05/2022 - 01/2010)
3.	Dhawan, Anil: 46 articles (01/2022 - 09/2002)
4.	Acute Liver Failure Study Group: 42 articles (01/2022 - 03/2003)
5.	Bernal, William: 41 articles (03/2022 - 02/2002)
6.	Jalan, Rajiv: 38 articles (01/2020 - 01/2002)
7.	Wendon, Julia: 34 articles (07/2021 - 02/2002)
8.	Butterworth, Roger F: 34 articles (12/2016 - 08/2002)
9.	Fontana, Robert J: 33 articles (10/2022 - 12/2002)
10.	Ramachandran, Anup: 28 articles (05/2022 - 02/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Acute Liver Failure:

1.	GalactosamineIBA 04/01/1999 - "We have established an improved model of fulminant hepatic failure in the pig by administration of an aminosugar d-galactosamine hydrochloride. " 01/01/2002 - "The model may be suitable for testing the efficacy of liver support device for fulminant hepatic failure, preferably 24-48 hours after administration of galactosamine." 04/01/1999 - "An improved model of galactosamine-induced fulminant hepatic failure in the pig." 01/01/2019 - "In this study, we aim to evaluate the therapeutic potential of UCBP for acute liver failure induced in a rat model by D-galactosamine (GalN). " 05/05/2014 - "The present study evaluated hepatoprotective effect of GPLC in d-Galactosamine (d-GalN) induced fulminant hepatic failure. "
2.	Acetaminophen (Paracetamol)FDA LinkGeneric 01/01/2017 - "Spontaneous survival rates improved significantly over time for those patients with acute liver failure due to paracetamol and non paracetamol aetiologies. " 01/01/2014 - "These data collectively demonstrated a RIPK-dependent necrotic mechanism operates in the APAP-injured liver and inhibition of this pathway may be beneficial for APAP-induced fulminant hepatic failure. " 01/01/2015 - "• Prognostication in acetaminophen-induced acute liver failure (APAP-ALF) is challenging beyond admission • Little has been published regarding the use of King's College Criteria (KCC) beyond admission and KCC has shown limited sensitivity in subsequent studies • Classification and Regression Tree (CART) methodology allows the development of predictive models using binary splits and offers an intuitive method for predicting outcome, using processes familiar to clinicians • Data from the ALFSG registry suggested that CART prognosis models for the APAP population offer improved sensitivity and model performance over traditional regression-based KCC, while maintaining similar accuracy and negligibly worse specificity • KCC-CART models offered modest improvement over traditional KCC, with NEW-CART models performing better than KCC-CART particularly at late time points." 10/01/2001 - "The anhepatic model is very useful for validating new supportive measures to bridge the period between the onset of fulminant hepatic failure and the time at which a suitable organ becomes available and, despite the many difficulties involved in their development, hepatotoxic models may still be useful for mimicking an acetaminophen overdose. " 09/01/2003 - "Our aim was to assess the efficacy of the liver dialysis unit (LDU) in the treatment of patients with acetaminophen-induced fulminant hepatic failure. "
3.	LipopolysaccharidesIBA 01/01/2014 - "Pretreatment of lipopolysaccharide (LPS) ameliorates D-GalN/LPS induced acute liver failure through TLR4 signaling pathway." 01/01/2023 - "Previous studies reported that a toxic pretreatment dose of TP leads to hepatic intolerance to exogenous lipopolysaccharide (LPS) stimulation, and to acute liver failure, in mice, but the immune mechanisms of TP-sensitised hepatocytes and the TP-induced excessive immune response to LPS stimulation are unknown. " 01/01/2012 - "In the present study, we investigate the effect of HO-1 in a model of fulminant hepatic failure induced by Propionibacterium acnes and lipopolysaccharide (LPS). " 01/27/2021 - "Lipopolysaccharide (LPS)-induced liver injury is the main factor in acute liver failure. " 08/01/2018 - "Oxidative stress is considered one of the major mechanisms underlying lipopolysaccharide (LPS)-induced acute liver failure (ALF). "
4.	Acetylcysteine (Siran)FDA LinkGeneric 05/01/2010 - "N-acetylcysteine seems to be beneficial for patients with acute liver failure caused by medications or herbal agents." 01/01/2018 - "One small trial (low quality evidence) found that acetylcysteine may reduce mortality in people with fulminant hepatic failure (Peto OR 0.29, 95% CI 0.09 to 0.94). " 05/01/2009 - "The aim of the study was to investigate the in vitro effects of sera from children with acute liver failure (ALF) who had received N-acetylcysteine (NAC) on the metabolic and synthetic activity of cryopreserved human hepatocytes. " 04/19/2006 - "N-acetylcysteine may reduce mortality in patients with fulminant hepatic failure (Peto OR 0.26, 95% CI 0.09 to 0.94, one trial). " 05/01/2000 - "This study suggests that N-acetylcysteine administration should be considered in all patients with acute liver failure."
5.	AlbuminsIBA 01/01/2022 - "The molecular adsorbent recirculating system removes water-soluble and albumin-bound toxins and may be beneficial for acute liver failure patients. " 08/01/2016 - "Peritoneal Albumin Dialysis as a Novel Approach for Liver Support: Study in a Porcine Model of Acute Hepatic Failure." 01/01/2011 - "This study provides the first evidence that intraperitoneal albumin may be able to attenuate systemic, pulmonary, and cerebral hemodynamic disturbances associated with acute liver failure." 01/01/2023 - "Here, we report that the biomolecular map of albumin is distinct and linked to severity and outcome in patients with acute liver failure (ALF). " 01/01/2023 - "Biomolecular map of albumin identifies signatures of severity and early mortality in acute liver failure."
6.	Thioacetamide (Thioacetamid)IBA 12/01/2011 - "Protective Effects of Platycodon grandiflorum Aqueous Extract on Thioacetamide-induced Fulminant Hepatic Failure in Mice." 12/01/2006 - "We investigated the protective effects of GB on thioacetamide (TAA)-induced fulminant hepatic failure in rats. " 12/01/2006 - "Protective effects of Gingko biloba on thioacetamide-induced fulminant hepatic failure in rats." 01/01/2022 - "In the present study, we explored the regulatory effects and mechanisms of SIRT6 in thioacetamide (TAA)-induced mice acute liver failure (ALF) models. " 01/01/2022 - "The study was carried out in male Sprague-Dawley rats with thioacetamide (TAA) induced acute liver failure at different stages 12 h, 24 h and 36 h. "
7.	CytokinesIBA 01/01/2010 - "These findings further support a role for selective brain-derived cytokines in the pathogenesis of the cerebral complications in acute liver failure and suggest that anti-inflammatory strategies could be beneficial in their prevention." 01/01/2012 - "To study immunological mechanisms of fulminant hepatic failure (FHF) derived from extensive liver lesions, 14 patients with FHF induced by different aetiologies were investigated by observance of both lymphocyte phenotyping and cytokine levels. " 09/01/2023 - "Correlation between serum pro-inflammatory cytokine levels and the prognosis of the patients with acute liver failure." 01/01/2018 - "No patterns of serum immune analytes were reflective of the etiologies of acute liver failure, but there were cytokine patterns that predicted prognosis in both acute DILI and ALF." 01/27/2015 - "The dysregulated cytokine metabolism and activity are crucial to the development of fulminant hepatic failure (FHF), and many different cytokines have been identified. "
8.	Transaminases (Aminotransferases)IBA 01/01/2006 - "Serum aminotransferase activity as a predictor for estimation of total clearance of hepatically metabolized drugs in rats with acute hepatic failure." 12/15/2023 - "Five presented with elevated aminotransferase levels, and one, with acute liver failure. " 03/03/2022 - "LEV-induced liver injury is a rare adverse reaction, ranging from asymptomatic elevated transaminases to fulminant liver failure. " 01/01/2021 - "Patients can experience transaminase elevation during DMT treatment, and in rare cases, idiosyncratic and unpredictable acute liver failure. " 01/01/2021 - "The involvement of the liver is a fairly common feature in DEN, and alterations range from asymptomatic elevation of transaminases to acute liver failure. "
9.	Carbon Tetrachloride (Tetrachloromethane)IBA 09/01/2015 - "This study aimed to determine whether a controlled portal blood arterialization by a liver extracorporeal device (L.E.O2 NARDO) is effective in treating acute hepatic failure (AHF) induced in swine by carbon tetrachloride (CCl4) administration. " 02/01/2014 - "Protective effects of Ephedra pachyclada extract on mouse models of carbon tetrachloride- induced chronic and acute liver failure." 01/01/2018 - "In the present study, we investigated and compared the therapeutic potentials of bone marrow-mesenchymal stem cells (BM-MSC) with those of adipose tissue (AT-MSC) in carbon tetrachloride (CCL4)-induced acute liver failure in mice. " 04/01/2015 - "In our study, we transplant allogenic adipose-derived stem cells (ASCs), not previously differentiated to hepatocytes, to treat acute liver failure induced by intraperitoneal administration of carbon tetrachloride (CCl4) in a Sprague-Dawley rat model. " 05/01/1998 - "The present study is an attempt to delineate location and function of transplanted hepatocytes and also the overall survival of these cells with a fluorescent in situ hybridization (FISH) technique using a Y-chromosome-specific probe in a carbon tetrachloride (CCl4)-induced mice model of fulminant hepatic failure. "
10.	Proteins (Proteins, Gene)FDA Link 04/01/2015 - "In this study, we investigated whether box-A gene transfer results in box-A protein production in rats and assessed therapeutic efficacy in vivo using an acute liver failure (ALF) model. " 05/28/2008 - "Our previous proteomic study showed that the senescence marker protein (SMP30) is selectively present in the plasma of a murine model of acute liver failure (ALF). " 10/01/2023 - "In addition, the acute liver failure model group showed an increase in Fe and MDA contents, decreased protein expressions of GPX4, and enhanced expression of 5-LOX, suggesting that ferroptosis was involved in acute liver failure in C57BL/6 mice. " 10/01/2023 - "[Activation of Yes-associated protein (YAP) improves mouse acute liver failure by alleviating ferroptosis]." 06/01/2023 - "A bioartificial transgenic porcine whole liver expressing human proteins alleviates acute liver failure in pigs."

Therapies and Procedures

1.	Liver Transplantation 12/28/2022 - "At present, liver transplantation is the most effective treatment for acute liver failure, but there is still an insufficient supply of liver sources and a poor prognosis. " 01/01/2020 - "Liver transplantation (LT) is the most effective treatment for patients with acute liver failure (ALF), but is limited by surgical risks and the need for life-long immunosuppression. " 01/28/2016 - "Liver transplantation has dramatically improved survival in patients with acute liver failure. " 03/01/2005 - "Liver transplantation is the best treatment for fulminant hepatic failure, with a 1-year patient survival rate of 61.3%. " 05/01/2004 - "The most successful therapy for acute liver failure is liver transplantation. "
2.	Transplantation 05/01/2011 - "Hepatocyte transplantation of 2×10(7) cells into spleen showed the best results in the acute hepatic failure rat." 05/01/1992 - "In contrast, the prognosis of fulminant hepatic failure has been dramatically improved by OLT, once efficient organization systems allowed adequate organ supply and emergency transplantation within a few hours. " 08/01/2003 - "Good results of transplantation for the management of fulminant hepatic failure depends on optimal selection of transplant candidates, which means identifying them early, reducing the waiting time, and excluding factors associated with a poor prognosis." 12/05/2017 - "Vascularized and functional liver tissues generated entirely from iPSCs significantly improved subsequent hepatic functionalization potentiated by stage-matched developmental progenitor interactions, enabling functional rescue against acute liver failure via transplantation. " 01/01/2011 - "Intraperitoneal transplantation of encapsulated immortalized hepatocytes significantly improved survival of mice with acute liver failure by providing metabolic support and without modifying liver regeneration. "
3.	Therapeutics 03/01/2019 - "Currently, the most effective treatment for DILI is to suspend the offending drug(s) and to avoid re-exposure, with no definitive therapy available for idiosyncratic DILI with or without acute liver failure. " 12/27/2018 - "Animal models of acute liver failure have also provided important insights into the safety, mechanisms, and efficacy of stem cell therapies. " 05/01/2011 - "Overall ELS therapy significantly improved survival in acute liver failure (risk ratio 0·70; P = 0·05). " 01/01/2023 - "Supportive extracorporeal therapies (SET), which temporarily support liver function and remove toxins, have shown promise in improving outcomes in acute liver failure (ALF). " 11/01/2022 - "Microcarrier-based mesenchymal stem cells (MSCs) delivery have attracted increasing attention in acute liver failure (ALF) therapy, while there is still room for improvement in terms of improving cell loading efficiency, enhancing anti-inflammatory features, and controlling cell release. "
4.	Artificial Liver (Bioartificial Liver) 01/01/2005 - "Animal models of fulminant hepatic failure (FHF) are important for studying the pathophysiology of this process and for evaluation of the efficacy of artificial and bioartificial liver support systems. " 11/01/2011 - "The application of newly developed multi-layer flat-plate bioartificial liver system was effective in the treatment of canines with acute liver failure." 03/01/2008 - "Incorporating the hepatocyte-like cells into a bioartificial liver device to treat fulminant hepatic failure improved animal survival, thereby underscoring the therapeutic potential of these cells." 11/01/2005 - "Thus, they may also be useful in the treatment of an acute liver failure patient with a bioartificial liver support system (BALSS). " 09/01/2001 - "Transient support using a hybrid artificial liver (HAL) device is a promising treatment for the patients with acute liver failure. "
5.	Plasma Exchange 10/21/2023 - "Efficacy of therapeutic plasma exchange in pediatric cases of acute liver failure as an extracorporeal liver support system." 05/01/1984 - "Plasma exchange using a large amount of fresh plasma, therefore, would be effective for the treatment of acute liver failure in its early stage." 01/01/2023 - "This study aimed to compare the efficacy of double plasma molecular adsorption system (DPMAS) with half-dose plasma exchange (PE) to that of full-dose PE in pediatric acute liver failure (PALF). " 01/01/2019 - "This study investigated the prognostic parameters and beneficial effects of repeat plasma exchange in children with acute liver failure (ALF). " 05/01/1994 - "In this study, this ratio was assessed before and after plasma exchange in 19 patients with acute hepatic failure. "