Abstract

Liver transplantation (LT) is an effective treatment for eligible patients with Acute Liver Failure (ALF). Prompt evaluation and decision making are required as there is often a small window of opportunity for LT before deterioration of patient health makes LT futile. The consequences of failure to recognize malignancy induced ALF may be catastrophic resulting in inappropriate LT and a common problem in this setting is the relatively normal parenchymal appearance of the liver with contrast imaging. Transjugular liver biopsy must be considered in all cases of ALF that are idiopathic, and mandatory if associated with clinical features suggestive of malignancy including hepatomegaly, hypercalcaemia and elevated LDH. Our case describes such a scenario and demonstrates the value of liver biopsy in such a setting.

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