Cited by 249Drug-Induced Hepatotoxicity and ProtectionLiver Disease and TransplantationPoisoning and overdose treatments

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Acute Liver Failure Including Acetaminophen Overdose

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Fontana, Robert J.·2008·Medical Clinics of North America

DOI 10.1016/j.mcna.2008.03.005PMC PMC2504411

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Abstract

Acute liver failure (ALF) is a dramatic, highly unpredictable clinical syndrome defined by the sudden onset of coagulopathy and encephalopathy. Acetaminophen overdose, the leading cause of ALF in the United States, has a 66% chance of recovery with early N-acetylcysteine treatment and supportive care. Cerebral edema and infectious complications are difficult to detect and treat in these patients and may cause irreversible brain damage and multiorgan failure. One-year survival after emergency liver transplantation is 70%, but 20% of listed patients die, highlighting the importance of early referral of patients who have ALF with a poor prognosis to a transplant center.

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Authors: Fontana, R. J.
Affiliations: University of Michigan (US)
Corresponding author: Fontana, Robert J.
ORCID: Fontana, Robert J.
Venue: Medical Clinics of North America
Publisher: Elsevier BV
Published: 2008-07
Volume: 92
Issue: 4
Pages: 761-794
ISSN: 0025-7125 (ISSN-L)
DOI: 10.1016/j.mcna.2008.03.005
PMC: PMC2504411
OpenAlex: W1979020366
Cited by: 249
References: 134
Citations by year: 2026: 7 · 2025: 8 · 2024: 8 · 2023: 16 · 2022: 9 · 2021: 26 · 2020: 19 · 2019: 18 · 2018: 19 · 2017: 18 · 2016: 15 · 2015: 13 · 2014: 14 · 2013: 11 · 2012: 9
FWCI: 1.88
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Medical Clinics of North America (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5u01dk065184-22)
National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK-065184, UO1 DK058389-07, U01DK058369)
National Center for Research Resources (M01RR000042)
Topics: Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
Keywords: acute liver failure, acetaminophen overdose, N-acetylcysteine, coagulopathy, encephalopathy, cerebral edema, infectious complications, liver transplantation, survival after liver transplantation
MeSH terms: Acetaminophen, Humans, Prognosis, Liver Transplantation, Liver Failure, Acute, Analgesics, Non-Narcotic, Drug Overdose

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Acute Liver Failure Including Acetaminophen Overdose

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