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By William M. Lee, Roger Williams, Jean-Pierre Benhamou, Jacques Bernuau

Acute liver failure (ALF), or fulminant hepatic failure, is a unique medical syndrome that crosses clinical disciplines. a comparatively infrequent , ALF is still an important concentration of medical and study realization. With the appearance of transplantation, the significance of figuring out administration of ALF has taken on a brand new urgency. during this first quantity devoted to ALF, the editors collect a exceptional group of members to explain the etiology, pathology and therapy of this significant syndrome. additionally lined are consensus recommendations in liver transplantation for ALF sufferers, in addition to descriptions of synthetic and bioartificial liver support units. a bit on destiny remedies comprises hepatocyte transplantation, auxiliary grafts and different transitority liver aid. remarkable for the excessive point of the authors' services, this complete quantity should still end up priceless.

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1986). However, there is no epidemiologic basis for implicating a virus or other transmissible agent in most cases. Multiple investigators have commented upon the absence of parenteral risk factors in such patients (Laskus et al. 1994; Williams and Wendon 1994; Wright et al. 1991) and no association with epidemics or clusters of hepatitis cases has been reported. The only direct evidence suggesting involvement of infectious agents has derived from several small studies. The putative non-ABCDE agent was suggested by discovery of Toga virus-like particles on electron microscopic examination of liver biopsies from nine patients with fulminant hepatic failure who presented to the King's College Liver Failure Unit (Fagan et al.

1993; Liang etal. 1993; Theilmann et al. 1992). Athough HCV infection has been implicated in a higher number of cases of fulminant viral hepatitis in Asian countries (Chu et al. 1994; Wu et al. 1994; Yoshiba et al. 1994), many of these cases involved co-infection with more than one virus or occurred in immunocompromised patients with serious underlying medical problems. All studies of posttransfusion hepatitis have noted a significantly lower incidence of acute liver failure in posttransfusion HCV infections than has been reported among posttransfusion HBV infections (McNeil et al.

In Progress in Liver Failure, eds. H. Popper, F. Schaffner, 282-98. New York: Grune and Stratton. , Roberts, J. and Lake, J. 1991. Hepatitis C virus not found in fulminant non-A non-B hepatitis. Ann Intern Med 115: 111-12. , Ohnishi, H. and Muto, Y. 1991. Hepatitis C virus in fulminant hepatic failure. N EngIJMedl24: 1895-6. , Okamoto, H. and Mayumi, M. 1994. Contribution of hepatitis C virus to non-A non-B fulminant hepatitis in Japan. Hepatology 19:829-35. 2 Viral hepatitis and acute liver failure Dwain L.

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