LIVER FAILURE IN NEONATES: CLINICAL EVALUATION AND SURGERY FOR LIVER TRANSPLANT

Abstract

Liver failure in neonates is a rare but extremely critical medical condition that can occur soon after birth. It involves the inability of the newborn's liver to perform its essential functions, putting the baby's life at risk. This challenging condition requires careful clinical evaluation and, in severe cases, consideration of liver transplant surgery as a last resort. Neonatal liver failure can manifest itself in several ways, with jaundice (yellowing of the skin and eyes) being one of the most visible symptoms. Other signs include abdominal distension, abnormal bleeding, feeding problems and inadequate growth. Objective: to analyze and synthesize the relevant studies available in the medical literature that address liver failure in neonates. Methodology: This systematic review followed the protocol established by the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). To identify relevant studies, we performed a comprehensive search of biomedical databases, including PubMed, Scielo, and Web of Science. The descriptors used for the search included "neonatal liver failure," "neonatal liver transplantation," "neonatal liver disease,” “Neonatal hepatic assessment” and “Neonatal liver surgery.” The inclusion criteria considered studies published in English, focusing on liver failure in neonates, clinical assessment and surgical treatment, and that presented clinically relevant results. Studies that did not meet these criteria or that had inadequate methodology were excluded. Results: 18 articles were selected. The review identified a set of studies that focused on clinical evaluation of neonates with liver failure, highlighting the importance of clinical markers, laboratory tests and imaging for diagnosis and risk stratification. Furthermore, studies were found that addressed the indications, surgical techniques and results of neonatal liver transplantation, showing variable rates of success and associated challenges Conclusion: Liver failure in neonates is a critical medical condition that requires specific clinical approaches and, in some cases, liver transplantation may be the only viable treatment option. This systematic review provides a comprehensive overview of the assessment and treatment of hepatic failure in neonates, highlighting the complexity and need for multidisciplinary approaches to improve clinical outcomes in this vulnerable population. It is essential that healthcare professionals are aware of current practices and available evidence to ensure the best care for newborns with this condition.