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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 scientific syndrome that crosses scientific disciplines. a comparatively infrequent situation, ALF continues to be a tremendous 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 assemble a special staff of individuals to explain the etiology, pathology and therapy of this crucial syndrome. additionally coated are consensus options in liver transplantation for ALF sufferers, in addition to descriptions of man-made and bioartificial liver support units. a piece on destiny remedies contains hepatocyte transplantation, auxiliary grafts and different transitority liver aid. remarkable for the excessive point of the authors' services, this accomplished quantity should still turn out helpful.

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Extra info for Acute Liver Failure

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Et al. 1993. Occult HBV in NANB fulminant hepatitis. Lancet 341: 123. , Purdy, M. et al. 1994. Hepatitis C and E in non-A non-B fulminant hepatic failure: a polymerase chain reaction and serological study. J Hepatol20: 580-8. , Rosina, F. et al. 1988. Serologic markers with fulminant hepatitis in persons positive for hepatitis B surface antigen. Ann Intern Med 108: 380-3. , Akahane, Y. et al. 1995. Hepatitis B virus strains with mutations in the core promoter in patients with fulminant hepatitis.

In fact, removal of calcium from extracellular medium may actually potentiate cell injury through generation of toxic oxygen species by mitochondria. The integrity of mitochondria and ATP production are critical in cell viability. Recently, much attention has been focused on mitochondria as a critical target leading to necrosis from toxins or anoxia (Imberti et al. 1992; Fujii et al. 1994). Two major modes of cell death have been recognized, apoptosis and lytic necrosis. Intrinsic toxins and anoxia usually kill cells via a lytic process which ultimately involves loss of mitochondrial integrity with opening of a megachannel, that is the mitochondrial membrane permeability transition, with loss of mitochondria membrane potential and matrix constituents and with subsequent cytoskeletal changes, swelling and rupture of cell membrane (lysis) (Zahrebelski et al.

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. Thiele INTRODUCTION Table 2 . 1 . Etiologies offulminant viral hepatitis Acute liver failure is a rare complication of acute viral hepatitis. Nevertheless, viral hepatitis is the leading cause of fulminant or subfulminant hepatic failure in most hospitals. Each of the well-characterized hepatitis viruses has been implicated in acute liver failure, but the relative frequency of this complication varies widely.

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