Skip to main content

Advertisement

SpringerLink
Log in

Acute (fulminant) liver failure: a clinical and imaging review

  • Review
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Acute liver failure (ALF) is a rare clinical entity with high morbidity and mortality frequently requiring liver transplantation for survival. Imaging, particularly with ultrasound, plays an important role, especially to distinguish patients with underlying chronic liver disease who have lower transplant priority. We discuss the clinical and imaging findings in the three subtypes of ALF using a multi-modality approach with an emphasis on ultrasound.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Williams R, Schalm SW, O’Grady JG. (1993) Acute liver failure: redefining the syndromes. Lancet 342(8866):273-275. https://doi.org/10.1016/0140-6736(93)91818-7

    Article  PubMed  Google Scholar 

  2. Goldberg DS, Forde KA, Carbonari DM, et al. (2015) Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system. Gastroenterology 148(7):1353-1361.e3. https://doi.org/10.1053/j.gastro.2015.02.050

    Article  PubMed  Google Scholar 

  3. Pievsky D, Rustgi N, Pyrsopoulos NT. (2018) Classification and Epidemiologic Aspects of Acute Liver Failure. Clin Liver Dis 22(2):229-241. https://doi.org/10.1016/j.cld.2018.01.001

    Article  PubMed  Google Scholar 

  4. Reuben A, Tillman H, Fontana RJ, et al. (2016) Outcomes in adults with acute liver failure between 1998 and 2013: An observational cohort study. Ann Intern Med 164(11):724-732. https://doi.org/10.7326/M15-2211

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bernal W, Hyyrylainen A, Gera A, et al. (2013) Lessons from look-back in acute liver failure? A single centre experience of 3300 patients. J Hepatol 59(1):74-80. https://doi.org/10.1016/j.jhep.2013.02.010

    Article  PubMed  Google Scholar 

  6. Stravitz RT, Lee WM. (2019) Acute liver failure. Lancet 394(10201):869-881. https://doi.org/10.1016/S0140-6736(19)31894-X

    Article  CAS  PubMed  Google Scholar 

  7. O’Grady JG, Alexander GJM, Hayllar KM, Williams R. (1989) Early indicators of prognosis in fulminant hepatic failure. Gastroenterology. https://doi.org/10.1016/0016-5085(89)90081-4

    Article  PubMed  Google Scholar 

  8. Optn. OPTN Policies. https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf. Accessed July 22, 2020.

  9. Quaglia A, Portmann BC, Knisely AS, et al. (2008) Auxiliary transplantation for acute liver failure: Histopathological study of native liver regeneration. Liver Transplant 14(10):1437-1448. https://doi.org/10.1002/lt.21568

    Article  Google Scholar 

  10. Zabron A, Quaglia A, Fatourou E, et al. (2018) Clinical and prognostic associations of liver volume determined by computed tomography in acute liver failure. Liver Int 38(9):1592-1601. https://doi.org/10.1111/liv.13725

    Article  CAS  PubMed  Google Scholar 

  11. Kim AI, Han SH, Tran DT, et al. (2013) Abdominal imaging can misdiagnose submassive hepatic necrosis as cirrhosis in acute liver failure. Clin Transplant 27(3):339-346. https://doi.org/10.1111/ctr.12123

    Article  Google Scholar 

  12. Poff JA, Coakley F V., Qayyum A, et al. (2008) Frequency and histopathologic basis of hepatic surface nodularity in patients with fulminant hepatic failure. Radiology 249(2):518-523. https://doi.org/10.1148/radiol.2492072168

    Article  PubMed  Google Scholar 

  13. Romero M, Palmer SL, Kahn JA, et al. (2014) Imaging appearance in acute liver failure: Correlation with clinical and pathology findings. Dig Dis Sci 59(8):1987-1995. https://doi.org/10.1007/s10620-014-3106-6

    Article  PubMed  Google Scholar 

  14. Ferral H, Behrens G, Lopera J. (2012) Budd-Chiari syndrome. Am J Roentgenol 199(4):737-745. https://doi.org/10.2214/AJR.12.9098

    Article  Google Scholar 

  15. Bhati CS, Bhatt AN, Starkey G, Hubscher SG, Bramhall SR. (2008) Acute liver failure due to primary angiosarcoma: A case report and review of literature. World J Surg Oncol https://doi.org/10.1186/1477-7819-6-104

    Article  PubMed  PubMed Central  Google Scholar 

  16. Stravitz RT, Lefkowitch JH, Fontana RJ, et al. (2011) Autoimmune acute liver failure: Proposed clinical and histological criteria. Hepatology https://doi.org/10.1002/hep.24080

    Article  PubMed  Google Scholar 

  17. Buechter M, Manka P, Heinemann FM, et al. (2018) Potential triggering factors of acute liver failure as a frst manifestation of autoimmune hepatitis-a single center experience of 52 adult patients. World J Gastroenterol 24(13):1410-1418. https://doi.org/10.3748/wjg.v24.i13.1410

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fujiwara K, Yasui S, Yokosuka O. (2013) Autoimmune acute liver failure: An emerging etiology for intractable acute liver failure. Hepatol Int 7(2):335-346. https://doi.org/10.1007/s12072-012-9402-3

    Article  PubMed  Google Scholar 

  19. McCaughan GW, Huynh JC, Feller R, Painter D, Waugh R, Sheil AGR. (1995) Fulminant hepatic failure post liver transplantation: clinical syndromes, correlations and outcomes. Transpl Int 8(1):20-26. https://doi.org/10.1007/BF00366706

    Article  CAS  PubMed  Google Scholar 

  20. Ribeiro-Jr MAF, Medrado MB, Rosa OM, et al. (2015)Liver transplantation after severe hepatic trauma: current indications and results. Arq Bras Cir Dig 28(4):286-289. https://doi.org/10.1590/S0102-6720201500040017

    Article  PubMed Central  Google Scholar 

  21. Kim TY, Kim DJ. (2013) Acute-on-chronic liver failure. Clin Mol Hepatol 19(4):349-359. https://doi.org/10.3350/cmh.2013.19.4.349

    Article  PubMed  PubMed Central  Google Scholar 

  22. Arroyo V, Moreau R, Jalan R. (2020) Acute-on-chronic liver failure. N Engl J Med 382(22):2137-2145. https://doi.org/10.1056/NEJMra1914900

    Article  CAS  PubMed  Google Scholar 

  23. Park SJ, Kim JD, Seo YS, et al. (2013) Computed tomography findings for predicting severe acute hepatitis with prolonged cholestasis. World J Gastroenterol https://doi.org/10.3748/wjg.v19.i16.2543

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Einstein Healthcare Network, 5501 Old York Road, Philadelphia, PA, 19141, USA

    Shuchi K. Rodgers & Mindy M. Horrow

Authors
  1. Shuchi K. Rodgers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mindy M. Horrow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shuchi K. Rodgers.

Ethics declarations

Conflict of interest

Spouse works for Bristol Myers Squibb.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodgers, S.K., Horrow, M.M. Acute (fulminant) liver failure: a clinical and imaging review. Abdom Radiol 46, 3117–3127 (2021). https://doi.org/10.1007/s00261-021-02973-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-021-02973-5

Keywords

Search

Navigation