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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 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    TOP

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    TOP

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    TOP

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    TOP

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    TOP

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:

  • 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.

Liver Transplant    TOP

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

Prevention    TOP

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

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:
...(Click grey area to select URL)
Updated March 12, 2014. Accessed February 3, 2017.
Last reviewed June 2017 by Daus Mahnke, MD

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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