Liver transplantation: Edited by John GossAcute liver failureNguyen, N Thao Ta; Vierling, John MbAuthor Information aMichael E. DeBakey Department of Surgery, USA bDepartment of Medicine and Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA Correspondence to Dr John M. Vierling, MD, FACP, 1709 Dryden, Suite 1500, Houston, TX 77030, USA Tel: +1 713 798 8355; fax: +1 713 798 8319; e-mail: [email protected] Current Opinion in Organ Transplantation: June 2011 - Volume 16 - Issue 3 - p 289-296 doi: 10.1097/MOT.0b013e328346c8ee Buy Metrics Abstract Purpose of review Clinical investigations in acute liver failure (ALF) continue to advance our understanding and capacity to diagnose and treat afflicted children and adults. The purpose of this review is to summarize the advances in clinical research in ALF during 2009–2010 that are pertinent to hepatologists and transplant surgeons caring for these critically ill patients. Recent findings Principal advances occurred in the characterization of cause and epidemiology, genetic susceptibility, assessment of prognosis for survival with medical therapy, clarification of long-term outcomes of transplantation for ALF, and publication of the final results of large randomized, placebo-controlled therapeutic trials. Summary Despite advances in our understanding, ALF remains a cause of significant mortality in children and adults because of the absence of curative medical therapy. Hence, only emergency liver transplantation is reliably life-saving. There is an urgent need for better understanding of the pathogenesis of ALF caused by different causes, of genetic susceptibility, development of validated prognostic indicators and application of this knowledge to devise new therapeutic strategies for testing in appropriately powered, randomized controlled trials. © 2011 Lippincott Williams & Wilkins, Inc.