• Liver Failure

    (Hepatic Failure)

    Definition

    The liver filters harmful items from the blood and helps your body process food. It also makes important proteins that helps the blood cells clot and fights infections. Failure is the gradual or sudden loss of liver function. It may be:
    • Chronic liver failure—the loss of liver function over time.
    • Acute liver failure—the sudden loss of liver function.
    The Liver
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    Causes

    Acute liver failure can occur after poisoning. A common cause is the improper use of certain medications, like acetaminophen, and herbal supplements. It may also be caused by a virus that attacks the liver.
    Chronic liver failure is often due to other medical conditions such as:
    • Cirrhosis
    • Nonalcoholic fatty liver disease
    • Primary sclerosing cholangitis, which is a disease of the bile ducts
    • Congenital defects, such as biliary atresia
    • Liver tumors
    • Metabolic causes, such as Wilson disease and Reye disease

    Risk Factors

    Factors that may increase your risk of acute liver failure include:
    • Exposure to toxins
    • Excess use of acetaminophen
    • Taking specific prescription medications or herbal supplements
    • Having viral hepatitis
    Factors that may increase your risk of chronic liver failure include:
    • Alcohol abuse
    • Having a condition that damages the liver over time, such as nonalcoholic fatty liver disease.

    Symptoms

    Symptoms of acute liver failure begin quickly. Symptoms of chronic liver failure will worsen over time.
    Symptoms of liver failure include:
    • Nausea and vomiting
    • Loss of appetite
    • Extreme fatigue
    • Diarrhea
    • Yellowing of the skin and eyes
    • Abdominal swelling
    • Unexplained bruising or bleeding
    • Confusion

    Diagnosis

    You will be asked about your symptoms and medical history. The doctor may ask about any medication or supplements you are taking, as well as alcohol use. A physical exam will be done.
    Blood and urine tests will help to show how well the liver is working. They can show changes in liver enzymes, the ability to clot, or any toxins that may be present.
    Images may be needed to check for signs of liver damage. This can be done with:
    A liver biopsy may be done to help find a cause for the liver failure and to look for damage. During the biopsy, a sample of liver tissue is removed for careful examination.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment will depend on the cause of your liver failure and whether it is acute or chronic. Options include:

    Medication

    Medications that cause liver failure will be stopped and/or changed. You may also be given medication:
    Medications that cause liver failure will be stopped and/or changed. You may also be given medication:
    • To treat the underlying cause of the liver failure
    • To treat liver failure complications, such as bleeding problems or seizures

    Diet and Lifestyle Changes

    Certain foods are harder on the liver. Some changes may need to be made to the diet. Common changes include limiting animal protein and sodium.
    Alcohol is also damaging to the liver and should be avoided. If you abuse alcohol or drugs, you may be referred to a rehabilitation center.
    Certain foods are harder on the liver. Some changes may need to be made to the diet. Common changes include limiting animal protein and sodium.
    Alcohol is also damaging to the liver and should be avoided. If you abuse alcohol or drugs, you may be referred to a rehabilitation center.

    Liver Transplant

    A liver transplant may be needed. It is only done if other treatments are not able to control the symptoms of liver failure.
    A liver transplant may be needed. It is only done if other treatments are not able to control the symptoms of liver failure.

    Prevention

    To decrease stress on the liver:
    • If you drink alcohol, drink in moderation. This means no more than 1 drink per day for women and 2 drinks per day for men.
    • Do not use IV drugs.
    • Practice safe sex. Hepatitis can be spread through unsafe sex.
    • Get vaccinated against hepatitis A and B.
    • Use medications as directed.
    • Avoid toxic chemicals, such as insecticides.
    • Maintain a healthy weight.

    RESOURCES

    American Liver Foundation http://www.liverfoundation.org

    Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

    CANADIAN RESOURCES

    Canadian Liver Foundation http://www.liver.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Acute liver failure. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T900055/Acute-liver-failure. Updated December 30, 2016. Accessed February 3, 2017.

    Acute liver failure. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/acute-liver-failure. Updated May 2016. Accessed February 3, 2017.

    Liver failure. Patient UK website. Available at: http://patient.info/doctor/liver-failure. Updated March 12, 2014. Accessed February 3, 2017.

    Revision Information

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