Meet the Expert 1

How Do I Manage Patients with Acute Liver Failure?

Session Overview

Acute liver failure (ALF) is a rapidly progressive and life-threatening condition that requires timely recognition, intensive monitoring, and close multidisciplinary collaboration. Through a case of hepatitis B virus-associated ALF complicated by hepatic encephalopathy, progressive hyperbilirubinemia, acute kidney injury (AKI), and multiorgan deterioration, this session will explore practical approaches to the management of critically ill patients with ALF.

What Will Be Covered

• Differentiation between acute liver failure and acute-on-chronic liver failure
• Recognition and evaluation of ALF-associated AKI
• Indications for ICU admission and essential monitoring strategies
• Principles of continuous renal replacement therapy (CRRT) prescription in ALF
• Management of hyperammonemia, fluid balance, acid-base disturbances, and electrolyte abnormalities
• The role of plasma exchange, molecular adsorbent recirculating system (MARS), and other extracorporeal liver support therapies
• Selection of bridging strategies while awaiting liver transplantation or hepatic recovery

What Participants Will Learn

Participants will learn how to identify high-risk clinical features, determine the appropriate level of monitoring, and integrate kidney and liver support therapies into a coordinated management plan. The session will also clarify when extracorporeal therapies should be considered and how their objectives differ from conventional kidney replacement therapy.

Target Audience

Nephrologists, hepatologists, intensivists, emergency physicians, transplant physicians, fellows, residents, critical care nurses, and other healthcare professionals involved in the care of patients with acute liver failure.

如何處理急性肝衰竭病人

課程簡介

急性肝衰竭（acute liver failure, ALF）病程進展迅速，常伴隨肝性腦病變、急性腎損傷（acute kidney injury, AKI）及多重器官功能異常，需要及早辨識、密切監測與跨專科整合照護。

本場次將以一名 hepatitis B virus-associated acute liver failure 病人為例。病人短期內出現進行性高膽紅素血症、肝性腦病變與 AKI，並迅速惡化。透過病例討論，專家將分享急性肝衰竭合併腎損傷時的評估、監測與 extracorporeal support 策略。

課程內容

• Acute liver failure 與 acute-on-chronic liver failure 的鑑別
• ALF-associated AKI 的病理機轉、辨識與評估
• ICU 收治時機及重要監測項目
• ALF 病人的 CRRT 適應症與處方設計
• Hyperammonemia、體液狀態、酸鹼與電解質異常的處理
• Plasma exchange、MARS 與其他 extracorporeal liver support therapies 的臨床角色
• 等待肝臟移植或肝功能恢復期間的 bridging strategy

參與者將學到

參與者將學習如何辨識高風險急性肝衰竭病人，評估 AKI 與神經學惡化風險，並根據病人的臨床狀況規劃 CRRT 與其他 extracorporeal support therapies。

課程亦將說明不同體外支持治療的目標、適用情境與限制，以及如何將其整合至肝臟移植前的照護策略。

適合對象