Management of acute liver failure-an updated literature review

Table 1 Pathophysiology of acute liver failure

Characteristic	DILI	Viral hepatitis	Autoimmune hepatitis	Ischemic hepatitis
Etiology	Drug dependent/intrinsic and drug independent/idiosyncratic	Hepatitis A, B, C, and E; less commonly CMV, HSV, EBV and VZV	Molecular mimicry; most common type 1 is associated with ANCA-abs and less common type 2 is associated with anti liver cytosol type 1 antibodies	Hypoperfusion to hepatic vasculature
Risk factors	Increased BMI, increased age, female sex, underlying liver disease (NAFLD), altered liver metabolism	Lack of access to clean water, unsanitary living conditions, IV drug use, risky sexual behaviors	Female sex, uncharacterized genetic predisposition	Most commonly associated with cardiac disease, respiratory failure and septic shock; severe burns, anaphylactic shock and thromboembolic event

DILI: Drug induced liver injury; BMI: Body mass index; NAFLD: Non alcoholic fatty liver disease; CMV: Cytomegalovirus; HSV: Herpes simplex virus; EBV: Epstein-Barr virus; VZV: Varicella-zoster virus; ANCA: Anti-neutrophilic cytoplasmic antibody.