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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 fight infections. Failure is the gradual or sudden loss of liver function. It may be:
  • Acute liver failure—the sudden loss of liver function
  • Chronic liver failure—the loss of liver function over time
The Liver
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Causes

Acute liver failure can occur after poisoning. A common cause is the improper use of certain medicine 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:

Risk Factors

Factors that may increase the chances of acute liver failure:
  • 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 use disorder
  • 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 past health. The doctor may ask about any medicine 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. The tests will look for changes in liver enzymes, the ability for blood to clot, or any toxins.
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, It is sent to a lab for examination.

Treatment

Treatment will depend on the cause of your liver failure and whether it is acute or chronic. Options include:

Medicine

Medicine that caused liver failure will be stopped and/or changed. You may also be given medicine:
  • 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 problems controlling alcohol or drug use, 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.

Prevention

To decrease stress on the liver:
  • If you drink alcohol, drink in moderation. This means no more than 1 drink a day for women and 2 drinks a 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
https://www.liverfoundation.org
Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

CANADIAN RESOURCES

Canadian Liver Foundation
https://www.liver.ca
Health Canada
https://www.canada.ca

References

Acute liver failure. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T900055/Acute-liver-failure . Updated October 20, 2017. Accessed April 3, 2018.
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 January 2018. Accessed April 3, 2018.
Liver failure. Patient website. Available at: https://patient.info/doctor/liver-failure. Updated March 12, 2014. Accessed April 3, 2018.

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