Liver failure can be acute, in which case it occurs suddenly in a previously healthy patient, or it can be the final stage of ongoing liver disease. Because the liver is an essential organ with metabolic and blood-filtering functions, when it fails permanently, the patient dies. In cases where liver failure is caused by a virus or poisoning, however, treatment may enable the liver to recover. In some situations, a liver transplant may provide recovery even from liver failure caused by chronic disease.
Causes of Liver Failure
Liver failure is often the result of an advanced disease process where liver damage has occurred because of long-term alcoholism, autoimmune hepatitis, or certain metabolic or vascular diseases. Hepatic (liver) cancer, or cancer that has metastasized from other organs can also result in liver failure. Acute liver failure may occur as a result of:
- Overdose of acetaminophen
- Certain prescription medications
- Some herbal supplements, such as kava, ephedra, and pennyroyal
- Hepatitis A, B or E
- Epstein-Barr virus
- Herpes simplex virus
- Toxins, including those found in poisonous mushrooms
Prescription medications known to have caused liver failure include some antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs) and anticonvulsants. In many cases, the cause of acute liver failure remains undetermined.
Symptoms of Liver Failure
The symptoms of liver failure demand urgent attention and include some or all of the following:
- Pain in the upper right abdomen
- Abdominal swelling
- Nausea and vomiting
- Mental confusion or disorientation
- Fatigue or sleepiness
- Feeling of being seriously ill
Patients in liver failure are extremely sick and require emergency intervention for survival.
Diagnosis of Liver Failure
While doctors may surmise liver failure from medical history and symptoms, the diagnosis can be confirmed through:
- Blood tests for both liver function and blood clotting
- Imaging tests like ultrasound scans
- Liver biopsy
Patients with liver failure are in danger of excessive bleeding, so if a liver biopsy is performed, it is often performed as a transjugular procedure. This involves a small incision in the neck through which a catheter is snaked down to the liver in order to minimize any bleeding.
Treatment of Liver Failure
When liver failure occurs because of poisoning or overdose, treatment with antidote medications may possibly reverse the effect of the toxins. When liver failure is the result of ongoing disease, such as cirrhosis, treatment involves an effort to preserve liver function in the region that remains in working order. In either case, if treatment is not effective, a liver transplant from a healthy donor may be the only remaining option.