LARS1 and infantile liver failure syndrome 1: Among the genetic and metabolic causes of recurrent acute liver failure (RALF), notable examples include leucyl-tRNA synthetase deficiency caused by mutations in the LARS gene, also referred to as infantile liver failure syndrome type 1 (ILFS1) (2); infantile liver failure syndrome type 2 (ILFS2), resulting from mutations in the NBAS gene (3–5); RINT1 deficiency (1); and various mitochondrial disorders (6).