Over the last three decades acute liver failure (ALF) has been transformed from a rare and
poorly understood condition with a near universally fatal outcome, to one with a well
characterized phenotype and disease course. Complex critical care protocols are now
applied and emergency liver transplantation (ELT) is an established treatment option. These
improvements in care are such that the majority of patients may now be expected to survive
(Fig. 1). Key features of the condition have changed dramatically over time, with a …