Aetiology Specific Management

Aetiology specific management for the various causes of ALF is shown in Table 1:

Table 1: Aetiology specific management [2-3]



Further action

Paracetamol poisoning Activate charcoal within 1 hour N-acetylcysteine even if >48 hours or if paracetamol poisoning cannot be excluded (has been shown to decrease mortality even in established hepatotoxicity)
Mushroom poisoning Penicillin G and silymarin.Consider administration of N-acetylcysteine List for transplant
Drug reactions Discontinue any possible offending drugs
Viral Hepatitis Acyclovir if HSV/VZV suspected
Wilson’s disease List for transplant
Autoimmune Hepatitis Corticosteroids List for transplant
HELLP Delivery of unborn child
Acute Ischaemic injury Cardiovascular support
Budd-Chiari Syndrome List for transplant if malignancy excluded
Malignant Infiltration N/A
Indeterminate N/A
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