D'Agostino Daniel, Diaz Silvia, Sanchez Maria Camila, Boldrini Gustavo
Gastroenterology-Hepatology Division, Liver-Intestinal Transplantation Center, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Curr Gastroenterol Rep. 2012 Jun;14(3):262-9. doi: 10.1007/s11894-012-0260-x.
Although the etiologies of pediatric acute liver failure (ALF) are diverse, ultimate pathophysiologic pathways and management challenges for these disorders, usually lethal in the pre-transplant era, are similar. This review considers particularly the mechanisms of, and monitoring for, intracranial hypertension and coagulopathy; summarizes detailed advice for management of the ALF-associated failures of multiple body systems; and reviews the variety of prognostic scores available to guide management and assist in choosing the patients most apt to benefit from liver transplantation and the optimal timing for such transplantation.
尽管小儿急性肝衰竭（ALF）的病因多种多样，但这些疾病在移植前时代通常是致命的，其最终的病理生理途径和管理挑战却相似。本综述特别考虑了颅内高压和凝血障碍的机制及监测；总结了针对ALF相关多系统功能衰竭管理的详细建议；并回顾了多种可用的预后评分，以指导管理并协助选择最有可能从肝移植中获益的患者以及确定此类移植的最佳时机。
