Aetiology Specific Management

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

Table 1: Aetiology specific management [2-3]
Aetiology	Treatment	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