title: Acute liver failure.
abstract: OBJECTIVE
  Clinical investigations in acute liver failure (ALF) continue to advance our understanding and capacity to diagnose and treat afflicted children and adults. The purpose of this review is to summarize the advances in clinical research in ALF during 2009-2010 that are pertinent to hepatologists and transplant surgeons caring for these critically ill patients.
  
  
  RESULTS
  Principal advances occurred in the characterization of cause and epidemiology, genetic susceptibility, assessment of prognosis for survival with medical therapy, clarification of long-term outcomes of transplantation for ALF, and publication of the final results of large randomized, placebo-controlled therapeutic trials.
  
  
  CONCLUSIONS
  Despite advances in our understanding, ALF remains a cause of significant mortality in children and adults because of the absence of curative medical therapy. Hence, only emergency liver transplantation is reliably life-saving. There is an urgent need for better understanding of the pathogenesis of ALF caused by different causes, of genetic susceptibility, development of validated prognostic indicators and application of this knowledge to devise new therapeutic strategies for testing in appropriately powered, randomized controlled trials.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: N Thao T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: John M
authors.initials: JM
authors.lastname: Vierling
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017114:Liver Failure, Acute / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019164:Liver, Artificial; D018579:Patient Selection; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome