Global Hospitals’ department of hepatology now views that a combination of optimised care and awareness could ensure optimal management for acute liver failure (ALF) mortality.

The leading multi-organ transplant and quaternary care hospital in Mumbai, has stated that ALF is life threatening and a catastrophic illness. Its main causes are viral hepatitis: Hep A, Hep E, Hep B, contaminated drinking water, drug induced with anti TB medication, painkillers, alternative medicines, toxins like yellow phosphorus and mushrooms besides many a times the cause remains unknown.

According to Prof. Mohamed Rela, director & group head, Institute of Liver Diseases and Transplantation, Global Hospitals Group, the initial care of ALF patients depends on prompt recognition of the condition and early detection of etiology. Patients with irreversible ALF need management at an advanced intensive care support unit, treatment of specific etiology and early detection of candidates for liver transplantation. The centre should be well equipped to handle all kinds of liver transplantation.

Liver diseases are amongst top ten killer diseases in India and is on the rise because of  lifestyle changes. Those suffering from chronic liver problems need recurrent and prolonged medical attention which can be made available at tertiary care centers. ALF, however, requires immediate decision making  and  referral to the right centre where facilities for optimal liver intensive care can enable a patient to have a spontaneous recovery. In case of a liver transplant then the centre should be equipped to do so. Of the ALF cases received at our unit we have been able to save 80 per cent. Of these 50 per cent were managed medically and 50 per cent underwent a transplant, said Dr. Samir Shah, HOD, Hepatology, Liver Intensive Care & Transplant Hepatology, Global Hospitals, Mumbai.

Dr. Vaishali Solao, chief liver intensivist, Department of Hepatology, Liver Intensive Care and Transplant Hepatology, Global Hospitals, Mumbai said, “About 10 years ago mortality rate amongst ALF patients was as high as 80 per cent and survival rate was a meager 20 per cent.”

Public health measures like vaccination and improved sanitation are among the factors resulting in the reduced incidence of these infections in the US and much of Western Europe, where drug-induced liver injury is the most common cause of ALF, said professor Julia Wendon, clinical director, critical care division, Kings College, London.

Dr. Ravi Mohanka, chief surgeon and HOD, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Global Hospitals, Mumbai, said, living donor liver transplant is an important option which can now be safely performed in experienced centers of excellence.