Knowledge Portal
Acute liver failure
Acute liver failure is a rare emergency characterised by rapid hepatic dysfunction, coagulopathy and encephalopathy in a person without established cirrhosis. Early aetiology-specific treatment, meticulous organ support and timely discussion with a specialist liver unit are central to care. Cerebral oedema and intracranial hypertension belong particularly to the acute liver failure phenotype and should not be assumed to accompany ordinary hepatic encephalopathy in cirrhosis.
Key information
Guidelines and position statements
Relevant clinical practice guidelines, practice guidance, consensus statements and position papers from professional bodies and expert groups.
EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure
EASL · clinical practice guideline · 2017
European recommendations covering diagnosis, cause-specific treatment, organ support, cerebral complications and emergency transplantation.
Open resource →Management of Acute Liver Failure
AASLD · revised position paper · 2011
The AASLD position paper and supporting material on early transplant-centre contact, aetiological investigation, intensive care and prognostic assessment.
Open resource →Further context
Other useful resources
Selected review articles, practical explainers, expert discussions, reference sites and e-learning from established providers.
Acute liver failure: A practical update
Fernández J, et al. JHEP Reports. 2024;6(9):101131.
A practical, open-access account of diagnosis, cause-specific therapy, organ support and transplant assessment.
Open resource →Acute liver failure
Maiwall R, et al. The Lancet. 2024;404(10454):789–802.
A broad contemporary review of epidemiology, pathophysiology, management and outcomes.
Open resource →Update on the management of acute liver failure
Nilsen O, Fisher C, Warrillow S. Current Opinion in Critical Care. 2025;31(2):219–227.
A concise critical-care update, particularly useful for current organ-support and neurological priorities.
Open resource →Defining and Managing Acute Liver Failure
AASLD Liver Fellow Network · clinical explainer · 2025
A clear introduction to diagnosis, initial investigation, prognosis and referral.
Open resource →Management of acute liver failure
Deranged Physiology · ICU revision chapter · updated 2025
An intensivist-oriented summary with links to companion chapters on diagnosis, physiology and prognosis.
Open resource →Acute Liver Failure – Presentation and Diagnosis
NHS England e-Learning for Healthcare · e-LA module
The first of two structured sessions; the companion module covers management and complications.
Open resource →Acute Liver Failure
Critical Care Reviews · curated review collection · updated 2026
A maintained collection of free reviews organised by background, complications and treatment.
Open resource →