RT Book, Section A1 Pievsky, Daniel A1 Pyrsopoulos, Nikolaos T. A2 Molmenti, Ernesto Pompeo A2 Santibañes, Martin de A2 Santibañes, Eduardo de SR Print(0) ID 1180107291 T1 Fulminant Hepatic Failure T2 Liver Transplantation: Operative Techniques and Medical Management YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781260462517 LK accesssurgery.mhmedical.com/content.aspx?aid=1180107291 RD 2024/03/28 AB Fulminant hepatic failure (FHF), now referred to as acute liver failure (ALF), is a rare but life-threatening condition that relies on early recognition and treatment to achieve optimal outcomes. The term “fulminant hepatic failure” was initially coined in 1970 by Charles Trey and Charles Davison, who defined FHF as “a severe liver injury, potentially reversible in nature and with onset of hepatic encephalopathy within 8 weeks of the first symptoms in the absence of pre-existing liver disease.” This definition was refined in 1993 by John O’Grady and colleagues, who subdivided the disease based on the time that it takes to progress from jaundice to encephalopathy. Their time frames were hyperacute, which progressed in ≤7 days; acute, which progressed in ≤4 weeks; and subacute, which progressed in ≤12 weeks. Currently, the most widely used definition is a variation of the original Trey and Davison model and recognizes ALF as evidence of an abnormality in coagulation (practically, an international normalized ratio [INR] >1.5) with any amount of encephalopathy in a patient without cirrhosis and an illness of <26 weeks in duration. The term FHF is still occasionally used to refer to a subtype of ALF where encephalopathy develops within 8 weeks in a patient with no prior liver disease.