Liver failure

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In medicine, liver failure, also called hepatic failure is "severe inability of the liver to perform its normal metabolic functions, as evidenced by severe jaundice and abnormal serum levels of ammonia; bilirubin; alkaline phosphatase; aspartate aminotransferase; lactate dehydrogenases; and albumin/globulin ratio."[1]


Among patients with hepatic encephalopathy grades I-II and international normalized ratio ≥ 1.5, intravenous N-acetylcysteine (NAC) for 72 hours may reduce the need for liver transplantation.[2] The trial did not appear to have patients with liver failure due to ethanol.


The King's College criteria (KCC) may be used.

The ALFSG index is a newer option that may be more accurate.[3]


  1. Anonymous (2021), Liver failure (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Lee WM, Hynan LS, Rossaro L, Fontana RJ, Stravitz RT, Larson AM et al. (2009). "Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure.". Gastroenterology 137 (3): 856-64, 864.e1. DOI:10.1053/j.gastro.2009.06.006. PMID 19524577. Research Blogging.
  3. Rutherford A, King LY, Hynan LS, Vedvyas C, Lin W, Lee WM et al. (2012). "Development of an accurate index for predicting outcomes of patients with acute liver failure.". Gastroenterology 143 (5): 1237-43. DOI:10.1053/j.gastro.2012.07.113. PMID 22885329. PMC PMC3480539. Research Blogging.