What is Liver Failure

Liver failure is a condition in which the liver loses its ability to function due to injury or disease. The liver is a large organ in the upper right-hand side of the abdomen.

It is involved in many important functions, including storing energy, producing fluids that the body needs, and removing harmful substances from the bloodstream.

Liver failure can develop quickly, over days or weeks (acute liver failure). It can also develop gradually, over months or years (chronic liver failure).

What are the causes?

There are many possible causes of liver failure, including:

• Liver infection (viral hepatitis).
• Alcohol abuse.
• An overdose of certain medicines. Acetaminophen overdose is a common cause.
• Liver disease.
• Ingesting poison from mushrooms or mold.

What are the signs or symptoms?

Symptoms of this condition may include:

• Yellowing of the skin and the whites of the eyes (jaundice).
• Bruising easily.
• Persistent bleeding.
• Itchy skin (pruritus).
• Red, spider-like lines on the skin.
• Loss of appetite.
• Nausea.
• Vomiting blood.
• Bloody bowel movements.
• Weight loss.
• Muscle loss.
• Jerky or floppy muscle movements, especially with hand movements (asterixis).
• Fluid buildup in the belly (ascites).
• Decreased urination. This may be a sign that your kidneys have stopped working (renal failure).
• Confusion and sleepiness.
• Difficulty sleeping.
• Mood and personality changes.
• Frequent infections.
• Breath that smells sweet or musty.
• Difficulty breathing.

How is this diagnosed?

This condition is diagnosed based on your symptoms, your medical history, and a physical exam. You may have tests, including:

• Blood tests.
• CT scan.
• MRI.
• Ultrasound.
• Removal of a small amount of liver tissue to be examined under a microscope (biopsy).

How is this treated?

Treatment depends on the cause and severity of your condition.

Treatment for chronic liver failure may include:

• Medicines to help reduce symptoms.
• Lifestyle changes, such as limiting salt and animal proteins in your diet. Foods that contain animal proteins include red meat, fish, and dairy products.

Acute or advanced (end stage) liver failure may require hospitalization. Treatment may include:

• Antibiotic medicine.
• IV fluids that contain sugar (glucose) and minerals (electrolytes).
• Flushing out toxic substances from the body using medicine (lactulose) or a cleansing procedure (enema).
• Adding certain amounts of the liquid part of blood (plasma) to your bloodstream (receiving a transfusion).
• Using an artificial kidney to filter your blood (hemodialysis) if you have renal failure.
• Breathing support and a breathing tube (respirator).
• Liver transplant. This is a surgery to replace your liver with another person’s liver (donor liver). This may be the best option if your liver has completely stopped functioning.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drink alcohol.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Follow instructions from your health care provider about eating and drinking restrictions. This may include:
  • Limiting the amount of animal protein that you eat.
  • Increasing the amount of plant-based protein that you eat. Foods that contain plant-based proteins include whole grains, nuts, and vegetables.
  • Taking vitamin supplements.
  • Limiting the amount of salt that you eat.
• Follow instructions from your health care provider about maintaining your vaccinations, especially vaccinations against hepatitis A and B.
• Exercise regularly, as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have symptoms that get worse.
• You lose a lot of weight without trying.
• You have a fever or chills.

Get help right away if:

• You become confused or very sleepy.
• You cannot take care of yourself or be taken care of at home.
• You are not urinating.
• You have difficulty breathing.
• You vomit blood.