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Survival rates way up for adults with acute liver failure

Survival rates for patients with acute liver failure have increased significantly over the past 16 years, according to a study published in Annals of Internal Medicine. The effects of specific changes in intensive care practice may contribute to this improvement.

Acute liver failure is a rare syndrome where liver function decreases severely and rapidly. Principle causes include acetaminophen overdose, ischemic and pregnancy-associated liver injury, and acute infection with hepatitis A or B virus, among others. Outcomes are more favorable for some causes than others, and survival after liver transplantation for patients with acute liver failure is good, but lower than among patients with cirrhosis who receive liver transplant.

The Acute Liver Failure Study Group established a registry in 1998 to better characterize the causes, clinical features, and outcomes of acute liver failure. Researchers sought to update the U.S. experience with acute liver failure at specialized liver transplant centers since the last published overview. Accordingly, they analyzed data on all patients with acute liver failure enrolled between 1998 and 2013, focusing on whether clinical features or outcomes have changed over time. They looked at causes and rates of transplant-free survival and whether utilization of liver transplantation changed in the 16-year observation period.

The researchers found that despite similar causes and severity of acute liver failure, outcomes have improved considerably, with slightly improved survival after liver transplantation and especially with improved survival without transplantation. The authors suggest that more effective intensive care unit management could be a contributing factor.