Debray D, Devictor D
Service d'hépatologie pédiatrique, hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Arch Pediatr. 1997 Jun;4(6):577-80. doi: 10.1016/s0929-693x(97)87583-5.
Among the main causes of acute liver failure (ALF) in children, metabolic diseases (especially in infants), viral and toxin or drug induced hepatitis are the most frequent. The cause remains, however, undetermined in about 30% of the cases. Management must be conducted in a pediatric hepatology unit or intensive care unit in relation with a pediatric transplant team in order: 1) to perform urgent etiological diagnosis; 2) to initiate specific therapy and symptomatic treatment; 3) to evaluate the severity and prognosis of liver disease for selection of children for emergency liver transplantation; 4) to evaluate contraindications to liver transplantation. The overall survival of post-emergency liver transplantation for ALF in children averages 65%.
在儿童急性肝衰竭（ALF）的主要病因中，代谢性疾病（尤其是婴儿）、病毒性肝炎以及毒素或药物性肝炎最为常见。然而，约30%的病例病因仍不明确。必须在儿科肝病科或重症监护病房，联合儿科移植团队进行治疗，目的如下：1）进行紧急病因诊断；2）启动特异性治疗和对症治疗；3）评估肝病的严重程度和预后，以选择适合进行紧急肝移植的儿童；4）评估肝移植的禁忌证。儿童ALF紧急肝移植后的总体生存率平均为65%。
