Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Gastroenterology, Kaiser Permanente, San Francisco, California, USA.
Am J Gastroenterol. 2023 Jul 1;118(7):1128-1153. doi: 10.14309/ajg.0000000000002340. Epub 2023 Mar 20.
Acute liver failure (ALF) is a rare, acute, potentially reversible condition resulting in severe liver impairment and rapid clinical deterioration in patients without preexisting liver disease. Due to the rarity of this condition, published studies are limited by the use of retrospective or prospective cohorts and lack of randomized controlled trials. Current guidelines represent the suggested approach to the identification, treatment, and management of ALF and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence was reviewed using the Grading of Recommendations, Assessment, Development and Evaluation process to develop recommendations. When no robust evidence was available, expert opinions were summarized using Key Concepts. Considering the variety of clinical presentations of ALF, individualization of care should be applied in specific clinical scenarios.
急性肝衰竭（ALF）是一种罕见的、急性的、潜在可逆转的疾病，导致无既往肝脏疾病的患者肝功能严重受损和迅速临床恶化。由于这种情况罕见，已发表的研究受到回顾性或前瞻性队列研究的限制，缺乏随机对照试验。当前的指南代表了识别、治疗和管理 ALF 的建议方法，也是美国胃肠病学院的正式实践建议。使用推荐分级的评估、制定与评价（GRADE）过程审查科学证据，以制定建议。当没有强有力的证据时，使用关键概念总结专家意见。鉴于 ALF 的临床表现多种多样，应在特定临床情况下进行个体化治疗。
