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vol.104 número11Paediatric pancreatic trauma: a review of the literature and results of a multicentre survey on patient managementLiver tumours in children: current surgical management and role of transplantation índice de autoresíndice de assuntospesquisa de artigos
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SAMJ: South African Medical Journal

versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574


HORSLEN, S. Acute liver failure and transplantation in children. SAMJ, S. Afr. med. j. [online]. 2014, vol.104, n.11, pp.808-812. ISSN 2078-5135.

Acute liver failure (ALF) was relatively easy to recognise in the days before liver transplantation became available as rescue therapy, because the diagnosis was based on end-stage disease manifestations such as profound coagulopathy, jaundice, encephalopathy and cerebral oedema (in a patient with no history of chronic liver disease). These criteria no longer help us in an era in which we struggle to define which patients are going to progress to this end-stage picture in the time necessary for evaluation and listing for life-saving transplantation. Ideally, identifying which patients will recover spontaneously or with appropriate treatment would relieve the justifiable concern that some patients receive a transplant when, given time, they would have recovered. Currently, the data to guide us in avoiding death without transplantation and unnecessary transplantation remain elusive.

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