Patient education: Acute liver failure in adults (The Basics)

What is acute liver failure? — 

This is when the liver stops working suddenly, over a few months or less. The liver is a big organ in the upper right side of the belly (figure 1). It does many things, including helping the body break down food and filtering harmful substances out of the blood. When the liver is damaged or injured, it can harm other parts of the body, including the kidneys and brain.

Acute liver failure is different from chronic liver failure. "Chronic" means that the liver stops working slowly over many months to years, for example, due to heavy alcohol use.

What causes acute liver failure? — 

There are many different causes. They include:

●Certain medicines – For example, taking too much acetaminophen (sample brand name: Tylenol) can cause liver injury. Some other medicines, drugs, and herbs can also harm the liver.

●Viral hepatitis – This is an infection that harms the liver. There are several different types of hepatitis. Other viral infections can also harm the liver, especially in people with a weak immune system.

●Poisoning – This can happen from eating wild mushrooms or other toxic substances.

●Other medical conditions – Examples include serious infection, heat stroke, and diseases that can reduce blood flow to the liver.

What are the symptoms of acute liver failure? — 

Symptoms of liver damage can include:

●Feeling very tired

●Loss of appetite

●Nausea or vomiting

●Pain in the upper belly

●Itchy skin

●Yellowing of the skin or whites of the eyes, called "jaundice"

●Swollen belly

Liver failure also affects the brain. This can cause:

●Confusion

●Sleep problems

●Trouble speaking

●Muscle spasms or twitches

●Coma

Many people with acute liver failure also have kidney damage.

Is there a test for acute liver failure? — 

Yes. If your doctor thinks you might have liver failure, they will do an exam and ask about your symptoms. They will ask about your health and any medicines you have taken recently.

They will also do tests, including:

●Blood tests – These can show if the liver is damaged. Different blood tests can also help your doctor figure out the cause.

●Imaging tests – These might include CT scan, MRI, or ultrasound. They create pictures of the inside of the body.

●Tests of your memory and thinking – The doctor or nurse will ask some questions to check your memory and thinking. For example, they might have you do simple number and word tests.

How is acute liver failure treated? — 

People with acute liver failure need to be treated in the hospital. This involves giving fluids and medicines by IV. (An IV is a thin tube that goes into a vein.) The staff will monitor the person's health, do regular blood tests, and make sure that they get the nutrition they need.

Other treatment depends on what caused the liver failure. For example:

●If the person took too much acetaminophen, doctors can give a medicine to lower their risk of liver damage. This must be given within 8 hours of an overdose.

●If the person has an infection or another condition, they might need medicines or other treatments.

Sometimes, the liver can heal with the treatments above. The chances of this depend on the person's age and health and what caused their liver failure. If there is too much damage, they might need a liver transplant. This is surgery to replace the damaged liver with a healthy one.

If you have been treated for acute liver failure, your doctor will want to see you for regular appointments. They will make sure that you are recovering well and check for any new problems.

More on this topic

Patient education: Drug-induced hepatitis (The Basics)
Patient education: Acetaminophen poisoning (The Basics)
Patient education: Hepatic encephalopathy (The Basics)
Patient education: Viral hepatitis panel (The Basics)
Patient education: Prothrombin time and INR (PT/INR) (The Basics)
Patient education: Liver transplant (The Basics)