Pediatric Acute Liver Failure

Pediatric acute liver failure (PALF) is a complex, life-threatening process characterized by coagulopathy and impaired hepatic function. The exact pathophysiology depends on the underlying cause, which can include infectious, toxic, immunemediated, metabolic, and genetic causes. In up to 50% of cases the cause of Approximately 12% of liver transplants in the United States are for cases of ALF.3 Any suspicion for PALF should lead to prompt referral to a pediatric liver transplant center. Although there is no specific definition for PALF, the following criteria established by the Pediatric Acute Liver Failure Study can be used as a guideline4: center dot Hepatic encephalopathy (HE) and an international normalized ratio (INR) greater than 1.5 that does not correct with vitamin K administration or