Kim Jin Dong
Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea.
Korean J Gastroenterol. 2023 Jan 25;81(1):17-28. doi: 10.4166/kjg.2022.148.
Acute liver failure (ALF) is a rare disease condition with a dynamic clinical course and catastrophic outcomes. Several etiologies are involved in ALF. Hepatitis A and B infections and indiscriminate use of untested herbs or supplemental agents are the most common causes of ALF in Korea. Noninvasive neurological monitoring tools have been used in patients with ALF in recent times. Ongoing improvements in intensive care, including continuous renal replacement therapy, therapeutic plasma exchange, vasopressor, and extracorporeal membrane oxygenation, have reduced the mortality rate of patients with ALF. However, liver transplantation is still the most effective treatment for patients with intractable ALF. There is a need for further research in the areas of better prognostication and precise selection of patients for emergency transplantation.
急性肝衰竭(ALF)是一种罕见的疾病状态,临床过程动态变化且预后严重。ALF涉及多种病因。甲型和乙型肝炎感染以及滥用未经检测的草药或补充剂是韩国ALF最常见的病因。近年来,非侵入性神经监测工具已应用于ALF患者。重症监护的不断改进,包括持续肾脏替代治疗、治疗性血浆置换、血管加压药和体外膜肺氧合,降低了ALF患者的死亡率。然而,肝移植仍然是治疗难治性ALF患者最有效的方法。在更好地进行预后评估和精确选择紧急移植患者方面,仍需要进一步研究。