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Cardiac failure, respiratory failure and toxic\u2010septic shock are the main underlying conditions accounting for more than 90% of cases, but <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> may also occur in other circumstances. Until recently, liver ischaemia, i.e. a drop in hepatic blood flow, was considered the leading, and even the sole, hemodynamic mechanism responsible for <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content>, and it was generally held that a shock state was required. In reality, other hemodynamic mechanisms of hypoxia, such as passive congestion of the liver, arterial hypoxaemia and dysoxia, play an important role while a shock state is observed in only 50% of cases. Accordingly, \u2018ischaemic hepatitis\u2019 and \u2018shock liver\u2019 are misnomers. Therapy of <jats:styled-content style=\"fixed-case\">HH<\/jats:styled-content> depends primarily on the nature of the underlying condition. 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