Acute liver failure (ALF) occurs when many cells in the liver die or become very damaged in a short amount of time. This causes the liver to fail to work as it should.
The liver removes toxins from the body, helps maintain blood glucose levels, is a part of the immune system and regulates blood clotting. When the liver fails it is an emergency and needs to be treated immediately.
Acute liver failure has many causes. Some causes of acute liver failure are:
Often the cause of acute liver failure in children cannot be found. One study showed that this was the case for about 44% of all children with acute liver failure. This number is about 63% in children with acute liver failure under 2 years of age.
Symptoms of acute liver failure can be like those of a virus. This can include upset stomach, feeling tired all the time, or throwing up. This can quickly progress to jaundice (yellowing of the skin), encephalopathy and coagulopathy (problem with blood clotting).
In encephalopathy the brain does not work the way it should. This happens when the liver is not able to break down or get rid of toxic products. A liver that is working like it should is able to break down toxins and carry them out of the liver.
Infants may be irritable, have crying spells and can't be made to feel better, or they might want to sleep more during the day than at night.
Older children may seem angry, have a hard time falling asleep, forget things, be confused or feel drowsy.
Lab studies and a physical exam can tell if there are signs of a liver problem. These include:
If there seems to be a liver problem, the child should be seen by an expert at a liver care/transplant center. The doctor there will figure out if the child’s cause of liver failure can be treated.
Treatment for acute liver failure depends on what caused the disease. Some causes can be treated by medicine and the liver will recover. If the liver does not recover from medication, a liver transplant may be required.
Whether a liver transplant is advised for the child depends on:
Acute liver failure in children is rare. The chance the child will recover depends mainly on the cause and their age. The stage of the disease and the amount of brain damage also affect recovery. If the liver heals itself, most often there is a full recovery.
The survival rate for children with acute liver failure who have a liver transplant is as high as 90%
Last Updated 08/2024
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