
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Acute liver failure classification
Introduction
Overview
Overview
Acute liver failure may be classified on the basis of the time interval between the onset of symptoms and the development of encephalopathy as hyperacute, acute, subacute, fulminant, subfulminant and late-onset. The different classification systems used are OβGrady system, Bernuau system, and Japanese system. This classification based on time duration provides helpful clues about etiology, complications, and prognosis such as in hyperacute cases, the cause is usually viral infections or acetaminophen toxicity. The subacute cases can be due to idiosyncratic drug reactions and can also be confused with chronic liver disease. The hyperacute liver failure has a better prognosis than subacute liver failure.
Classification
Classification
Acute liver failure may be classified on the basis of the duration of the symptoms between the onset of jaundice to the onset of encephalopathy. The different classification systems based on the number of weeks from the appearance of jaundice to the encephalopathy are:[1][2][3][4][5][6]
| Classification system | Duration |
|---|---|
| OβGrady System |
|
| Bernuau System |
|
| Japanese System |
|
- This classification based on time duration provides helpful clues about etiology, complications, and prognosis such as in hyperacute cases, the cause is usually viral infections or acetaminophen toxicity.
- The subacute cases can be due to idiosyncratic drug reactions and can also be confused with chronic liver disease.
- The hyperacute liver failure has a better prognosis than subacute liver failure.
Classification based on etiology
There is no established classification of acute liver failure on the basis of etiology. However, it can be classified on the basis of etiology as:[7][8]
Viral
- The viruses associated with hepatitis are hepatitis A, B, C, D, E, cytomegalovirus (CMV), varicella, herpes simplex virus (HSV) and adenovirus.
Metabolic
Vascular
Drugs and Toxins
Other
References
References
- β O’Grady JG, Schalm SW, Williams R. Acute liver failure: redefining the syndromes. Lancet 1993;342:273-5. PMID 8101303.
- β O’Grady JG (2005). “Acute liver failure”. Postgraduate medical journal. 81 (953): 148β54. doi:10.1136/pgmj.2004.026005. PMIDΒ 15749789.
- β Williams R (1996). “Classification, etiology, and considerations of outcome in acute liver failure”. Semin Liver Dis. 16 (4): 343β8. doi:10.1055/s-2007-1007247. PMIDΒ 9027947.
- β O’Grady JG, Schalm SW, Williams R (1993). “Acute liver failure: redefining the syndromes”. Lancet. 342 (8866): 273β5. PMIDΒ 8101303.
- β Bernuau J, Rueff B, Benhamou JP (1986). “Fulminant and subfulminant liver failure: definitions and causes”. Semin Liver Dis. 6 (2): 97β106. doi:10.1055/s-2008-1040593. PMIDΒ 3529410.
- β Mochida S, Nakayama N, Matsui A, Nagoshi S, Fujiwara K (2008). “Re-evaluation of the Guideline published by the Acute Liver Failure Study Group of Japan in 1996 to determine the indications of liver transplantation in patients with fulminant hepatitis”. Hepatol Res. 38 (10): 970β9. doi:10.1111/j.1872-034X.2008.00368.x. PMIDΒ 18462374.
- β Lee WM, Squires RH, Nyberg SL, Doo E, Hoofnagle JH (2008). “Acute liver failure: Summary of a workshop”. Hepatology. 47 (4): 1401β15. doi:10.1002/hep.22177. PMCΒ 3381946. PMIDΒ 18318440.
- β Lee WM (2008). “Etiologies of acute liver failure”. Semin. Liver Dis. 28 (2): 142β52. doi:10.1055/s-2008-1073114. PMIDΒ 18452114.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2] Aditya Govindavarjhulla, M.B.B.S. [3]
