ABSTRACT
Approximately 30,000 patients die each year from end-stage liver disease in the United States. About 80% of these patients have decompensated chronic liver disease, typically caused by alcoholism or chronic hepatitic C infection, and less commonly by a genetic — hepatocellular or anatomic — defect of liver function, or cancer. The other 20% die of acute liver failure (without preexisting chronic liver disease), which has various etiologies, including ischemia-reperfusion injury during liver surgery, acetaminophen poisoning, viral hepatitis, severe sepsis, idiosyncratic drug reactions, etc. Acute liver failure symptoms develop over a period of 6 weeks to 6 months and lead to death in over 80% of the cases, usually from cerebral edema, complications due to coagulopathy, and renal dysfunction. A more severe form of acute liver failure — fulminant hepatic failure — is characterized by a more rapid evolution (2 to 6 weeks).
