Acute Liver Failure is the rapid development of dysfunction or failure of the Liver [hepatocellular dysfunction].

Encephalopathy (a mental status changes) is one of the many complications of this condition. Jaundice and impaired protein syntheses are other complications.

Usually the patient will have a history of liver disease, Hepatitis, Alcohol use, medication overdose, or another medical condition that is causing the damage to the liver.

However, in some cases of Liver Failure, there is a complete absence of a prior history of liver disease. These cases are rare and additional studies, evaluation, and often treatment are required.

The Liver is a central mode of control for many enzymes and detoxification of the blood

Symptoms of Liver Failure:

–  Jaundice
–  Severe damage to liver cells
–  Decrease coagulation
–  Thormbocytopenia
–  Increase platelet function
–  Renal failure is seen in 40-50% of the time
–  Encephalopathy

*** Individuals can present as hepatocellular injury, hepatic encephalopathy, infection, GI bleed, or multiple organ failure


Potential Causes

–  Drugs
–  Alcohol
–  Viruses
–  Toxins
–  Reye Syndrome
–  Wilsons Disease
–  and others

Drug Examples Affecting the Liver Include:

–  Acetaminophen – most common drug
–  Halothane
–  Isoniazid
–  Valproate
–  Sulfonamides
–  Phenytoin
–  Thiazolidinedione
–  Some herbal remedies
–  and others

Classification [from 1993]:

1.)  Hyperacute as within 1 week
2.)  Acute as 8-28 days
3.)  Subacute as 4-12 weeks

Diagnosis of Liver Failure

–  Physical Exam
–  Lab work
–  CT of liver/abdomen
–  MRI of abdomen
–  Liver biopsy
–  Others

Treatment Options:

Treatment largely depends on the severity and the classification. In acute issues, short term treatment, addressing the underlinging condition is important.

Long term treatment could include increased medications to address the secondary problems associated with liver failure. This can include edema, weight gain, ammonia levels and more.

–  Hospital Admission is often necessary
–  Nutrition improvement
–  Liver transplant
–  Dialysis