Liver Failure

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
• Mushroom poisoning (rare)

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:

• Ultrasound
• CT scan
• MRI scan

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.

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

Other options may be diet and lifestyle changes, such as:

• Eating foods that are easier on the liver
• Taking supplements
• Not using substances that can harm the liver, such as alcohol and certain drugs
• Getting treatment for alcohol and drug abuse disorders

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.