Definition
Liver failure is when the liver does not work well. The liver helps the body remove toxins, process food, and store energy.
Liver failure may be:
- Acute —sudden loss of liver function
- Chronic—loss of liver function over time
Liver failure can be fatal.
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Causes
Acute liver failure is often caused by medicines, toxins, or viruses that harm the liver.
Chronic liver failure is often caused by medical problems such as:
- Cirrhosis
- Nonalcoholic fatty liver disease
- Primary sclerosing cholangitis—a bile duct disease
- Birth defects, such as biliary atresia
- Liver tumors
- Wilson disease and Reye syndrome
Risk Factors
Things that raise the risk of acute liver failure are:
- Excess use of acetaminophen
- Certain medicines or herbal supplements
- Exposure to toxins
- Certain illegal drugs
- Heat stroke
- Viral hepatitis
Things that raise the risk of chronic liver failure are:
- Alcohol use disorder
- Health problems that damage the liver over time
Symptoms
Symptoms of acute liver failure begin quickly. Symptoms of chronic liver failure worsen over time.
Symptoms may be:
- Nausea and vomiting
- Loss of hunger
- Tiredness
- Loose stool (poop)
- Yellowing of the skin and eyes
- Belly swelling
- Unexplained bruising or bleeding
- Problems thinking
Diagnosis
The doctor will ask about symptoms and past health. The doctor may ask about medicines, supplements, and alcohol use. A physical exam will be done.
Blood and urine tests will help to show how well the liver is working.
Images may be needed to check for signs of liver damage. This can be done with:
A liver biopsy may be done. A sample of liver tissue is taken and tested. It will look for causes of liver failure.
Other tests may be done to check for damage to the brain.
Treatment
Treatment depends on the cause and type of liver failure. Acute liver failure needs supportive care in the hospital. Fast treatment can be life-saving.
Options may be:
Medicine
Medicine that caused liver failure will be stopped and/or changed. Medicines may be given to:
- Treat the underlying cause of the liver failure
- Treat problems from liver failure such as bleeding or seizures
Diet and Lifestyle Changes
Certain foods are harder on the liver. Diet changes and supplements may be needed.
Alcohol is also damaging to the liver. Alcohol use will need to be stopped. Treatment may be needed for alcohol and drug use problems.
Liver Transplant
If other treatments do not help, a liver transplant may be needed.
Prevention
To help reduce the risk of liver damage:
- Do not drink alcohol, or limit alcohol to:
- No more than 1 drink a day for women
- No more than 2 drinks a day for men
- Do not use IV drugs.
- Practice safe sex.
- Get vaccinated against hepatitis A and B.
- Use medicines 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
REFERENCES:
Acute liver failure. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-liver-failure. Accessed August 10, 2021.
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. Accessed August 10, 2021.
Sivell C. Nonalcoholic fatty liver disease: a silent epidemic. Gastroenterol Nurs. 2019;42(5):428-434.
Last reviewed July 2021 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD Last Updated: 8/10/2021