Acute liver failure in paracetamol overdose: management, transplantation and best practice

Abstract

Paracetamol is the most common drug taken in overdose in the UK, and this is recognised as a major cause of acute liver failure. However, death rates from acute liver failure have fallen, due to the rapid availability and accessibility of the antidote, N-acetylcysteine (NAC). This article critically evaluates the literature on the assessment and management of patients presenting with paracetamol overdose, in order to promote best practice within their clinical team. It includes discussion of presentation, risk factors and complications, as well as treatment and referral to specialist centres for liver transplantation.