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Multiorgan failure (MOF) eventually develops, leading to death. Many different etiologies have been identified, with acetaminophen (APAP) overdose and viral hepatitis being the most common causes worldwide. The pathophysiology of ALF can be divided into cause\u2010specific liver injury pathophysiologies and pathophysiology related to occurrence of secondary MOF. In terms of liver injury pathophysiology, APAP toxicity is the most well known. Secondary MOF is often a result of the initial massive proinflammatory response generating a systemic inflammatory response syndrome followed by a compensatory anti\u2010inflammatory response leading to immune cell dysfunction and sepsis. As the liver is a tremendously important metabolic organ involved in energy metabolism, protein synthesis, fat metabolism, and glycemic control, multiple aspects of nutrition also need to be considered as part of the overall pathophysiology of ALF.<\/jats:p>","DOI":"10.1002\/ncp.10459","type":"journal-article","created":{"date-parts":[[2019,12,15]],"date-time":"2019-12-15T22:18:43Z","timestamp":1576448323000},"page":"24-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":137,"title":["Pathophysiology of Acute Liver Failure"],"prefix":"10.1002","volume":"35","author":[{"given":"Victor","family":"Dong","sequence":"first","affiliation":[{"name":"Interdepartmental Division of Critical Care University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Nanchal","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, and Sleep Medicine Medical 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