Transplantation for acute liver failure: perioperative management.
OBJECTIVE
A number of conditions can lead to acute liver failure. Determining the cause has important prognostic implications that guide decisions regarding the likelihood of spontaneous recovery, or conversely, the need for transplantation.


RESULTS
Neurological deterioration is associated with intracranial hypertension, which requires meticulous management. The decision to employ invasive intracranial pressure monitoring is controversial because of associated risks and the lack of controlled studies. Recent literature addressing the use of intracranial pressure monitoring is reviewed.


CONCLUSIONS
Even tertiary care units that specialize in liver disease treat acute liver failure patients infrequently. Knowledge of the latest guidelines and treatment protocols can lead to improved patient care.
Steadman
Randolph H
RH
Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-7403, USA. rsteadman@mednet.ucla.edu
Van Rensburg
Adriaan
A
Kramer
David J
DJ
D001929:Brain Edema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D003422:Critical Care; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D007427:Intracranial Pressure; D017114:Liver Failure, Acute / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D016343:Monitoring, Intraoperative / Q000009:adverse effects; D019990:Perioperative Care; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012121:Respiration, Artificial / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome