Management of liver failure.

In considering a patient in liver failure it is important to distinguish between fulminant hepatic failure (FHF) and episodes of acute hepatic decompensation in patients suffering from chronic liver disease (CLD), as the basis for treatment differs. Fulminant hepatic failure has been defined by Trey and Davidson (1970) as encephalopathy developing within 8 weeks of the onset of symptoms in a patient whose liver function before the onset of the illness was presumed to be normal. In these patients the liver damage is potentially reversible. Treatment is supportive, and is aimed at the associated multi-organ failure. Artificial liver support systems are used to buy time, and to give more chance for the surviving hepatocytes to regenerate, for it is on regeneration that survival depends.