Fetal surgery firsts
The first open fetal surgery in the world was performed at UCSF in the early 1980s.
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Acute liver failure (ALF) is sudden, severe liver damage occurring in people with no prior history of liver disease. When this happens, the liver can no longer perform critical functions, including removing toxins from the body and stabilizing blood sugar levels. People with ALF become sick quickly – often in one week or less – and need immediate medical attention. If untreated, the condition can be fatal.
Though more common in adults, ALF can also affect babies, children and adolescents. In up to half of cases, the cause of the condition is unclear. Known causes of ALF include:
This rare condition affects an estimated 2,000 people per year in the United States.
Early symptoms of ALF may resemble common childhood illnesses such as the flu. These include:
As the disease progresses, it can affect processes throughout the body, including in the brain. Signs that the liver is failing include:
Your child's doctor will start by collecting details about medical history and conducting a physical exam. This can help pinpoint a potential cause of the ALF, such as an acetaminophen overdose or a recent infection. The exam may include tests of your child's mental state to check for brain dysfunction, a condition known as encephalopathy.
Blood and urine tests also help assess liver damage. These tests look for:
The doctor may also order an abdominal ultrasound or a liver biopsy to check the condition of the liver look for the cause of the ALF.
Many patients with ALF can make a full recovery with medical supervision and the use of certain medications. If the liver is not recovering or it is so severely damaged that ALF is causing problems with the brain or other organs, your child may need a liver transplant.
Finding the cause of ALF can help determine what approach is needed, but doctors can't always predict how patients will respond to treatment. Getting treatment in a hospital that offers comprehensive care, including liver transplantation, can help ensure the best outcomes for patients with ALF.
If ALF is caused by acetaminophen poisoning, an antidote called N-acetylcysteine (NAC) can help restore healthy liver function, especially if started within 12 hours of the overdose. NAC may also help treat ALF stemming from other causes.
Other medications may be used to address the root cause of the ALF and reduce further liver damage. These include:
Children with liver failure require close observation and support, often in the hospital's intensive care unit. In the hospital, your child's doctor will manage symptoms of ALF and work to prevent complications. This can include:
If ALF cannot be reversed with medications and medical supervision, your child may need a liver transplant. Your child may receive a healthy liver from a deceased donor or receive part of the organ from a living donor. Because patients with ALF need treatment urgently, they are given very high priority for a donated liver.
UCSF Benioff Children's Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.
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Fetal surgery firsts