Treatment of Acute Liver Failure in Budd-Chiari Syndrome

Acute liver failure (ALF) arising from Budd-Chiari syndrome presents a distinct clinical challenge, requiring management strategies tailored to the underlying hepatic venous outflow obstruction.

Clinical scenario: ALF developing in the setting of Budd-Chiari syndrome. In the absence of contraindications to anticoagulation, anticoagulation therapy is the recommended initial intervention in this population.

For patients who do not adequately respond to initial medical and interventional management, the evidence-based protocol recommends escalation to a transplant-based surgical approach. The full indications, patient selection criteria, and complete management pathway are detailed in the protocol.

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References

In patients with Budd-Chiari syndrome-induced ALF, we recommend heparin as initial therapy in the absence of contraindications to anticoagulation.

In patients with BCS-induced ALF who do not respond to medical and therapeutic interventions, we recommend LT.

DOI: 10.14309/ajg.0000000000002340

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