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Review
. 2017 May;112(4):371-381.
doi: 10.1007/s00063-017-0282-0. Epub 2017 Apr 25.

[Acute liver failure]

[Article in German]
A Koch  1 , C Trautwein  2 , F Tacke  2
Affiliations
Review

[Acute liver failure]

[Article in German]
A Koch et al. Med Klin Intensivmed Notfmed. 2017 May.

Abstract
in English, German

Acute liver failure (ALF) is a rare, but life-threatening disease that is characterized by the acute onset of jaundice, coagulopathy, and hepatic encephalopathy (HE) in patients without pre-existing liver disease. Main causes in Germany are drug toxicity, acetaminophen overdose, and viral hepatitis (A, B, E). For the initial assessment of patients with ALF and the diagnostic algorithm, the early detection of HE, exclusion of liver cirrhosis, immediate diagnosis of the underlying etiology, and evaluation for the necessity of liver transplantation (LT) are critical. Intensive care therapeutic measures aim at preventing or treating complications of ALF. Potentially, plasmapheresis (full plasma exchange) offers a survival benefit for ALF patients who do not undergo LT. The King's College criteria and the Clichy criteria are used as prognostic tools for the indication for LT.

Das akute Leberversagen (ALV) ist ein seltenes, aber lebensbedrohliches Krankheitsbild, das durch das akute Auftreten der Trias aus Ikterus, Koagulopathie und hepatischer Enzephalopathie (HE) bei Patienten ohne vorbestehende Lebererkrankung gekennzeichnet ist. Häufigste Ursachen in Deutschland sind Medikamententoxizität, Paracetamolintoxikation und Virushepatitis (A, B, E). In der Ersteinschätzung von Patienten mit ALV sind die frühzeitige Diagnose einer HE, der Ausschluss einer zugrunde liegenden Leberzirrhose, die rasche Diagnostik der potenziellen Ursache und die Abschätzung der Notwendigkeit zur Lebertransplantation (LTX) entscheidend. Intensivmedizinische Maßnahmen dienen der Vermeidung von Komplikationen bzw. ihrer rechtzeitigen konsequenten Behandlung. Die Plasmapherese bietet möglicherweise einen Überlebensvorteil für Patienten, die keine LTX erhalten (können). Als Prognosekriterien für die Indikation zur LTX werden die King’s-College- und die Clichy-Kriterien verwendet.

Keywords: Acetaminophen; Hepatic encephalopathy; Liver transplantation; N-acetylcysteine; Plasmapheresis.

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References

    1. Canbay A, Tacke F, Hadem J, Trautwein C, Gerken G, Manns MP. Acute liver failure: a life-threatening disease. Dtsch Arztebl Int. 2011;108:714–720. - PMC - PubMed
    1. Rutter K, Horvatits T, Drolz A, Roedl K, Siedler S, Kluge S, Fuhrmann V. Acute liver failure. Med Klin Intensivmed Notfmed. 2016 - PMC - PubMed
    1. Bernal W, Wendon J. Acute liver failure. N Engl J Med. 2013;369:2525–2534. doi: 10.1056/NEJMra1208937. - DOI - PubMed
    1. Streetz KL, Tacke F, Koch A, Trautwein C. Acute liver failure. Diagnosis and therapy. Med Klin Intensivmed Notfmed. 2013;108:639–645. doi: 10.1007/s00063-013-0285-4. - DOI - PMC - PubMed
    1. Hadem J, Tacke F, Bruns T, Langgartner J, Strnad P, Denk GU, Fikatas P, Manns MP, Hofmann WP, Gerken G, et al. Etiologies and outcomes of acute liver failure in Germany. Clin Gastroenterol Hepatol. 2012;10:664–669.e2. doi: 10.1016/j.cgh.2012.02.016. - DOI - PubMed

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