**Liver Transplantation**

[74] Llovet JM, Fuster J, Bruix J. Barcelona-clinic liver cancer G. The Barcelona approach: Diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transplantation.

[75] Woo HY, Heo J. New perspectives on the management of hepatocellular carcinoma with portal vein thrombosis. Clinical and Molecular Hepatology. 2015;**21**(2):115-121

2004;**10**(2 Suppl 1):S115-S120

154 Liver Research and Clinical Management

**Chapter 8**

**Provisional chapter**

**Liver Transplantation in Acute Liver Failure: Indications**

The term acute liver failure (ALF) refers to the acute (<26 weeks) and severe worsening in liver function associated with encephalopathy in a person with no underlying chronic liver disease. ALF constitutes a critical clinical syndrome that is potentially reversible but has a very variable prognosis. No specific treatment is available, and liver transplantation (LT) is the treatment of choice in many cases. However, the challenge remains of identifying those patients with a poor likelihood of spontaneous recovery of liver function and for whom the indication and time of LT in order to guarantee survival (based on identification of prognostic factors) need to be established. In Europe, 8% of LT are due to ALF. Although the results of LT due to ALF have improved over recent years, they are still far from those seen after

**Keywords:** liver transplant, acute liver failure, prognostic score, outcome

Budd-Chiari syndrome, as well as reactivation of the hepatitis B virus (HBV) [2].

**Liver Transplantation in Acute Liver Failure: Indications** 

DOI: 10.5772/intechopen.72664

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Acute liver failure (ALF) is defined as the presence of acute liver injury, that is, a rise in transaminases at least three times the upper limit of normal, jaundice, and coagulopathy, together with the onset of encephalopathy in a person with no previous liver disease [1]. Exceptions to this definition include the acute onset of Wilson disease, autoimmune hepatitis, and the

Though no consensus exists on the severity of the coagulopathy or the encephalopathy marking the transition from acute liver injury to ALF, an INR ≥1.5 and any degree of encephalopathy are generally accepted [3]. Clinically, ALF is classified according to the interval between the onset of jaundice, considered as the initial symptom, and the encephalopathy. The ALF is considered to be hyperacute if the encephalopathy appears within

Rocío González Grande and Miguel Jiménez Pérez

Rocío González Grande and Miguel Jiménez Pérez

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72664

**and Outcome**

**Abstract**

elective LT.

**1. Introduction**

**and Outcome**

**Provisional chapter**
