Acute liver failure in neonates

Acute liver failure (ALF) in neonates is a rare but often fatal event. Though in adults and older children, a main symptom of ALF is hepatic encephalopathy, this is very difficult to diagnose and prove in infants. Causes of ALF in neonates encompass metabolic, infectious and haematological disorders, congenital vascular/heart abnormalities, and drugs. Infants with ALF should only be treated in specialised paediatric hepatology centres with facilities for liver transplantation, since for many liver transplant, with a long term survival of over 60%, is the only therapeutic option.