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Liver failure

Introduction

Also called hepatic failure, liver failure is a life-threatening condition in which the liver is unable to perform its functions both synthetic and metabolic. There are two kinds of liver failure, which are acute and chronic. Acute is when liver failure happens rapidly, in days to weeks, in a patient with no preexisting liver disease and chronic is when liver failure happens gradually. Sometimes patients with preexisting chronic liver disease can develop a rapid decline in liver function and is called 'acute on chronic' liver failure.

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Causes

Causes of acute liver failure:

Causes of chronic liver failure:

symptoms

A person suffering from liver failure will show symptoms such as

  • Yellowing of skin and eyes (jaundice)
  • Disorientation, altered sleep or coma (Encephalopathy)
  • Abdominal distension due to fluid accumulation (Ascites)
  • Swelling of legs (pedal edema)
  • Blood vomiting (hematemesis)
  • Melena (passing hair colored dark stool)
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Treatment

Acute liver failure is mainly supportive. A severe form of acute liver failure where the patient rapidly deteriorating may need ICU support. Liver dialysis may be required to tide over the crisis. Few will require liver transplantation.

Management of chronic liver failure is mainly the management of complications like ascites, esophageal & gastric varices, encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, spontaneous bacterial peritonitis, Porto-pulmonary hypertension, and hydrothorax. Decompensated liver disease requires liver transplantation.

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