[Conservative therapy of liver failure]

Abstract

Hepatic failure is characterized by decreasing liver function involving synthesis, regulation and detoxification. In most cases, acute liver failure results from acute viral hepatitis. Furthermore, intoxications or metabolic decompensation can cause fulminant hepatic failure. Chronic liver failure is defined as progressive decline in liver function in previously existing liver disease, mostly liver cirrhosis. Clinical manifestation of both acute and chronic hepatic failure is determined by hepatic encephalopathy and severe disturbance of the hemostatic system. Causal therapy does not exist; the inducing agent or reason should be eliminated. The major supportive strategy comprises removal of toxic metabolites from the intestine and stabilization of the hemostatic system. As prognosis of both acute and chronic liver failure is very poor, orthotopic liver transplantation represents the ultima ratio therapy.