Aetiology and outcome of adult and paediatric acute liver failure in Europe

Acute liver failure (ALF) is rare but life-threatening. Common causes include intoxications, infections and metabolic disorders. Indeterminate etiology is still frequent. No systematic data on incidence, causes and outcome of ALF across Europe are available. Via an online survey we reached out to European Reference Network Centres on rare liver diseases. Numbers and aetiology of ALF cases during 2020 were retrieved and diagnostic and treatment availabilities assessed. In total, 455 cases (306 adult, 149 paediatric) were reported from 36 centres from 20 countries. Intoxication was the most common cause in adult and paediatric care. The number of cases with indeterminate aetiology is low. Diagnostic tools and specific treatment options are broadly available within this network. This is the first approach to report on aetiology and outcome of ALF in the paediatric and adult population in Europe. High diagnostic yield and standard of care reflects the expert status of involved centres.