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Acute Liver Failure Including Acetaminophen Overdose
Open accessAbstract
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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“Intentional and unintentional overdose emerged as a leading cause of acute liver failure in many countries and remains one of the most common causes of drug-induced liver injury worldwide ( 12 – 14 ].”
From Paracetamol: A History of Assumptions, Errors, and Evidence Reversals in Pain Management (2026) · cites this paper as [12]
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“Severe toxicity has long been recognized, but it was historically dismissed as a distinct complication of acute overdose [ 12 , 13 ].”
From Paracetamol: A History of Assumptions, Errors, and Evidence Reversals in Pain Management (2026) · cites this paper as [12]
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Metadata
- 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)
- 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
- 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
About these checks
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