Thus patients should be referred to a transplant center, supported aggressively, and listed for transplant. Children with AFLF have the highest priority for regional sharing of donor organs. The option of live-related organ donation can be explored. Patients with proven mitochondrial defects, sometimes uncovered by Valproate have a poor neurological outcome and should not be transplanted. Urgent exclusion of these conditions may be warranted, and 'antioxidant liver rescue' therapy attempted.
Genetic advice is mandatory.
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