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Acute Liver Failure is a rare condition. It is the rapid loss of liver function that occurs in days or weeks. This condition may not necessarily occur in those who have a pre-existing liver condition. Acute Liver Failure is not as common as Chronic Liver Failure.

Acute Liver Failure can cause serious complications such as excessive bleeding and increasing pressure on the brain. As Acute Liver Failure is a medical emergency, it requires hospitalization. In many situations, a liver transplant may be the only for Acute Liver Failure.

What are the signs and symptoms of Acute Liver Failure?

Some of the signs and symptoms of acute liver failure are:

  • Jaundice- yellowing of the skin and eyeballs
  • Nausea and Vomiting
  • Sleepiness
  • Pain in the upper abdomen
  • Confusion and disorientation

What are the complications of Liver Failure?

Some of the complications of liver failure are:

  • Cerebral Edema: This is the condition of excessive fluid in the brain which can build up pressure in the brain.
  • Bleeding: Due to the failure, the liver can is unable to make enough clotting factors which helps in blood clotting. This condition may be difficult to control.
  • Infections: Those with acute liver failure are more susceptible to infections mostly in the blood, respiratory and urinary tracts.
  • Kidney Failure: If one has an acetaminophen overdose along with liver failure, it can damage the kidneys along with the liver.

What is the diagnosis of Acute Liver Failure?

Some of the tests and procedures of Acute Liver Failure include:

  • Blood Tests: Blood tests play a key role in determining how well the liver works. A test called prothrombin time test measures the time taken for the blood to clot. In acute liver failure, the blood doesn’t clot as easily as it otherwise should.
  • Imaging Tests: The doctor may ask for an ultrasound test to look at the liver. The test helps to understand the liver damage and the cause for the same. The doctor can also recommend a CT scan or an MRI to look at the liver and blood vessels.
  • Examining Liver Tissue: A doctor may conduct a liver biopsy which is the removal of a small piece of tissue. This helps the doctor to understand the reason for liver failure. The doctor may also perform a transjugular liver biopsy to avoid the risk of bleeding.

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Those with Acute Liver Failure are more commonly treated in the intensive care unit of a medical facility. Some of the treatments include:

When the acute liver failure can't be reversed through medication, the patient may require a liver transplant. In a liver transplant, the surgeon removes the damaged liver with a healthy liver from a deceased donor, or parts of a healthy liver from a living donor.

Sometimes acute liver failure can be caused due to acetaminophen overdose. This can be treated with acetylcysteine medication. This medication is also used to treat other causes of acute liver failure. Mushroom poisoning and other types of poisoning can also be treated with medicinal drugs.

To control the signs and symptoms of acute liver failure, the doctor may prevent those complications through screening for Infections, preventing severe bleeding and relieving pressure caused by excessive fluid in the brain.

What are the causes of Acute Liver Failure?
  • Prescription medicines: Some medicines such as antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs can cause acute liver failure.
  • Herbal Supplements: Some herbal supplements such as skullcap, kava have been linked to acute liver failure.
  • Acetaminophen Overdose: The most common cause of acute liver failure is the overconsumption of acetaminophen. Taking higher than recommended doses of acetaminophen every day can cause acute liver failure.
  • Toxins: Toxins such as poisonous wild mushrooms can cause acute liver failure.
  • Hepatitis: Hepatitis A, B, and E can cause acute liver failure. Some other viruses such as herpes simplex virus can also cause this failure.
  • Autoimmune Disease: Autoimmune disease is a disease in which the immune system attacks the liver cell which can cause injury and inflammation.
  • Metabolic Diseases: Rare metabolic diseases can also cause acute liver failure infrequently.
  • Cancer: Cancer in the liver or spreading to the liver from other parts of the body can cause acute liver failure.
  • Shock: Sepsis and shock can impair blood flow to the liver causing liver failure.
  • Drink Alcohol in moderation: Those who drink alcohol should limit it to one drink in case of women of all ages and men older than 65. Younger men should limit it to two drinks in a day.
  • Follow instructions on medicines: It is very important to check the package of medicines for the recommended dosage. Especially in the case of liver disease, it is always better to ask the doctor if it is safe to take any kind of medicine.
  • Avoid any risky behavior: It is important to stop the use of any intravenous drugs. One should not share needles and use condoms during sexual activity.
  • Vaccination: Those with chronic liver disease or a history of hepatitis infection should get a vaccination for hepatitis.
  • Avoid contact with blood and fluids of others: If the needles are not clean, it can cause the spread of hepatitis viruses. Sharing the same razor blades and toothbrushes can also spread infection.
  • Avoid wild mushrooms: As it is difficult to tell the difference between a safe and wild mushroom, one should avoid eating it.
  • Take care of skin: When using toxic chemicals, always cover the skin and face with sleeves and a mask.
  • Healthy Weight: It is important to maintain a healthy weight as obesity can cause nonalcoholic fatty liver disease leading to cirrhosis.

Frequently Asked Questions

Q.1.Why is the liver important?

The liver is the largest organ in the body and it performs many difficult functions that are essential for life. The liver converts the food we eat into stored energy and chemicals necessary for life and growth. It acts as a filter to detoxify and excrete substances that would otherwise be harmful (like alcohol). It processes medications absorbed from the digestive system and enables the body to use them effectively. The liver also creates and exports important chemicals used by the body. It is impossible to live without the liver and its health plays a major role in your quality of life.

The liver is the only organ in the body that is able to regenerate. Most organs in the body replace damage with scar tissue, but the liver is able to replace damaged tissue with new cells. However, the long-term complications of liver disease occur when regeneration is either incomplete or prevented by progressive development of scar tissue within the liver. This occurs when the damaging agent (a virus, drug, alcohol, etc.) continues to attack the liver and prevents complete regeneration. Severe scaring is called cirrhosis.

The majority of patients with Hepatitis C are found to have a risk factor such as needle exposure, blood exposure, tattooing, body piercing or sexual exposure which would allow for an exchange of blood or bodily fluids. A small percentage of patients have no identifiable risk factor and presumably acquired the disease through inadvertent exposure such as sharing a razor.

The most important thing to recognize about liver disease is that up to 50 percent of individuals with liver disease have no symptoms. The most common symptoms are very non-specific and they include fatigue or excessive tiredness, lack of drive, and occasionally itching. Signs of liver disease that are more prominent are jaundice, or yellowing of the eyes and skin, dark urine, very pale or light colored stool or bowel movements, bleeding from the GI tract, mental confusion, and retention of fluids in the abdomen or belly.

In the early stages of cirrhosis, you may not have any symptoms. The only way to know for sure is to get examined by your provider. Early diagnosis of cirrhosis can help prevent symptoms from developing. It's also important to see your provider if you do have symptoms. These can include fluid buildup in the belly, swelling in the lower legs, small spidery-veins on your skin, easy bruising, itching, or shortness of breath. Your provider might be able to diagnose cirrhosis during an office examination. Sometimes, however, it may require blood tests, abdominal ultrasound, or a CT scan.

Cirrhosis is advanced scarring (fibrosis) in the liver. Many people who develop cirrhosis show no signs at all--they look exactly the same as they did before. For some people with cirrhosis, the scarring in the liver causes a buildup of bile and increases the level of bilirubin (a brownish-yellow substance found in bile) in the bloodstream. High bilirubin levels can make the skin appear yellow. So, although the skin of some people with cirrhosis may turn yellow, it does not happen to most people.

It is also important to know that a yellowish skin tone may be caused by cirrhosis, but it also could be caused by a different illness such as pancreatic cancer or colon cancer that has spread to the liver.

No, cirrhosis can result from many things, not just heavy drinking. When something attacks and damages the liver, liver cells are killed and scar tissue is formed. When the whole liver is scarred, it shrinks, hardens, and can stop working properly. This is called cirrhosis. Cirrhosis is the most severe stage of liver damage. Heavy drinking is certainly one cause, but any condition or illness that affects the liver over a long period of time eventually could lead to cirrhosis. That includes hepatitis B, hepatitis C, non-alcoholic steatohepatitis, autoimmune hepatitis, primary biliary cirrhosis (PBC), and other diseases. Some people have more than one of these conditions (for example, alcohol use plus hepatitis B infection). Sometimes those combinations will speed up the development of cirrhosis.

The most common agent is probably acetaminophen (Tylenol, although it is contained in many OTC medications). It remains the safest medication for fevers, aches, and pains, but only taken in small recommended amounts. Amounts greater than those recommended can result in liver damage or failure. Acetaminophen overdose is a common reason for considering a liver transplant. A more serious problem occurs in patients who drink alcohol on a daily basis, particularly more than two drinks. In those situations, normal doses of Tylenol three to four times a day can produce severe liver damage. The same problem can occur in patients with other liver diseases such as viral hepatitis. Additionally, more common toxins tend to be those that are inhaled, such as cleaning solvents, aerosolized paints, thinners, etc., which are more dangerous with an underlying condition.

There are vaccines to prevent hepatitis A and B. Hepatitis B is a disease that could be completely eradicated with universal vaccination. It is now one part of the newborn vaccination series. Attempts are ongoing to vaccinate all children by the time they reach junior high age. Adults who are in high-risk occupations such as the healthcare field or carry out high-risk activities, such as IV drug use and multiple sexual partners, should also be vaccinated. Hepatitis A vaccine is recommended in a number of child-care settings and should be discussed with your pediatrician. Adults or children traveling to areas of the world where hepatitis A is very common, including all underdeveloped or poorly developed countries, should be vaccinated before they go. Any individual with underlying chronic liver disease that is not due to hepatitis B, particularly those with hepatitis C or cirrhosis, should be vaccinated against both hepatitis A and hepatitis B, unless they are already immune.

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