Treatment of Acute Liver Failure in Budd-Chiari Syndrome
When acute liver failure (ALF) develops in the setting of Budd-Chiari syndrome, the underlying aetiology directly shapes the treatment strategy. Identifying this specific cause early is critical, as it determines the recommended first-line intervention.
This protocol applies to patients presenting with ALF where the precipitating cause is Budd-Chiari syndrome. The presence of this condition must be established before treatment is initiated, as it drives a distinct management approach compared with other causes of ALF.
For ALF due to Budd-Chiari syndrome, prompt initiation of anticoagulation therapy is the cornerstone of first-line management — provided there are no contraindications. The complete regimen, including agent selection and decision criteria, is available in the full structured protocol.
DOI: 10.14309/ajg.0000000000002340
In patients with Budd-Chiari syndrome-induced ALF, we recommend heparin as initial therapy in the absence of contraindications to anticoagulation.
In the absence of contraindications, IV heparin should be started promptly.