Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, APHP-Bicêtre Hospital, Paris 11-Sud University, 94275 Le Kremlin-Bicêtre, France.
Expert Rev Gastroenterol Hepatol. 2011 Dec;5(6):717-29. doi: 10.1586/egh.11.57.
Acute liver failure (ALF) is a rare but devastating syndrome. ALF in children differs from that observed in adults in both the etiologic spectrum and the clinical picture. Specific therapy to promote liver recovery is often not available and the underlying cause of the liver failure is often not determined. Management requires a multidisciplinary approach and should focus on preventing or treating complications and arranging for early referral to a transplant center. Although liver transplantation has increased the chance of survival, children who have ALF still face an increased risk of death, both while on the waiting list and after emergency liver transplantation. This article will review the current knowledge of the epidemiology, pathobiology and treatment of ALF in neonates, infants and children, and discuss some recent controversies.
急性肝衰竭（ALF）是一种罕见但具有破坏性的综合征。儿童 ALF 在病因谱和临床表现上与成人观察到的 ALF 不同。促进肝脏恢复的特定治疗方法通常不可用，而且肝衰竭的潜在原因通常也无法确定。治疗需要多学科方法，并应侧重于预防或治疗并发症，并安排尽早转至移植中心。虽然肝移植增加了生存机会，但患有 ALF 的儿童在等待名单上和紧急肝移植后仍面临更高的死亡风险。本文将综述新生儿、婴儿和儿童 ALF 的流行病学、病理生物学和治疗的最新知识，并讨论一些近期的争议。
