Data on early infantile liver failure (EILF) are rare and mostly restricted to Caucasians. The purpose of this study was to characterise the genesis and prognosis of EILF among Arabs, as well as to discover prognostic variables. From 2008 to 2018, researchers examined the database of 524 babies with liver impairment and found instances of EILF defined as the presence of a biochemical pattern of liver disease and INR 2 with start before 3 months of life. The primary outcomes were mortality or liver transplantation (LT), as well as survival with native liver. There were 42 instances of EILF found. The aetiology was unknown in 14 cases and established in 27: galactosemia, tyrosinemia, neonatal hemochromatosis (NH), hemophagocytic lymphohistiocytosis (HLH), mitochondrial hepatopathy, and other. LF resolved in 15 patients, either spontaneously or in response to particular medication; 23 died; and 4 had LT. The optimal cut-off value of blood total bilirubin for prediction of study outcomes was 120 mol/L, according to ROC analysis. Among the diagnostic categories, galactosemia and tyrosinemia indicated a favourable result, but idiopathic diagnosis suggested a negative outcome.

In Saudi Arabia, galactosemia, tyrosinemia, NH, HLH, and mitochondrial hepatopathy are the key actors in EILF, as they are in Western nations. Galactosemia and tyrosinemia indicate a favourable prognosis, but an idiopathic diagnosis indicates a bad prognosis.