Description

Acute liver failure is loss of liver function that occurs rapidly — in days or weeks, usually in a person who does not have liver disease, pre-existing. It is most often caused by the hepatitis a virus, or medications, such as acetaminophen. Acute liver failure is less common than chronic liver failure, which develops more slowly.

The acute liver failure, also known as fulminant hepatic failure, can cause serious complications, such as bleeding and increased pressure in the brain. It is a medical emergency that requires hospitalization.

Depending on the cause, acute liver failure, at times it can be reversed with treatment. In many situations, however, a liver transplant may be the only cure.

Symptoms

The symptoms of acute liver failure may include:

  • Yellowing of the skin and eyes called jaundice.
  • Pain in the upper right part of the belly of the area, called the abdomen.
  • A bloated belly, known as ascites.
  • Nausea and vomiting.
  • A general feeling of discomfort, known as upset.
  • Disorientation or confusion.
  • The drowsiness.
  • The breath with a musty or sweet smell.
  • The tremors.

When to see a doctor

Acute liver failure can develop quickly in a healthy person, and life is in danger. If you or someone you know suddenly develops a yellowing of the eyes or of the skin; pain in the upper part of the abdomen; or any unusual changes in mental status, personality or behavior, seek medical attention immediately.

Causes

Acute liver failure occurs when the cells of the liver is seriously damaged and are not able to function. Possible causes include:

  • Overdose of paracetamol.Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the united States. Outside of the united States, acetaminophen is known as paracetamol. Acute liver failure can occur after large doses of paracetamol, or after the largest of the recommended dose each day for several days. If you or someone you know has taken an overdose of paracetamol, seek medical attention as soon as possible. The treatment can help prevent liver failure. Do not wait for the symptoms of liver failure.
  • Hepatitis and other viruses. Hepatitis a, hepatitis B, and hepatitis, And increase the risk of acute liver failure. Other viruses that can increase the risk include Epstein-Barr virus, cytomegalovirus, and herpes simplex virus.
  • The prescription of drugs. Some prescription medications, including antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants, can cause acute liver failure.
  • Herbal supplements. Herbal medications and supplements, including kava, ephedra, skullcap and pennyroyal, have been linked to acute liver failure.
  • Toxins. The toxins that can cause acute liver failure include the poisonous mushroom Amanita phalloides, which sometimes is confused with one that is safe to eat. The carbon tetrachloride is another toxin that can cause acute liver failure. It is an industrial chemical found in refrigerants and solvents, waxes, varnishes, and other materials.
  • Autoimmune disease. Liver failure can be caused by autoimmune hepatitis, a disease in which the immune system attacks liver cells, causing inflammation and injury.
  • Diseases of the veins in the liver. Vascular diseases, such as Budd-Chiari syndrome, can cause blockages in the veins of the liver and lead to acute liver failure.
  • The metabolic disease. Rare metabolic diseases, such as Wilson's disease and acute fatty liver of pregnancy, at times, cause of acute liver failure.
  • Cancer. Cancer that starts in or spreads to the liver can cause liver failure.
  • The shock. Overwhelming infection, called sepsis, and shock can severely reduce the flow of blood to the liver, causing liver failure.
  • A heat stroke. The extreme physical activity in a hot environment can trigger acute liver failure.

Overdose of paracetamol. Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the united States. Outside of the united States, acetaminophen is known as paracetamol. Acute liver failure can occur after large doses of paracetamol, or after the largest of the recommended dose each day for several days.

If you or someone you know has taken an overdose of paracetamol, seek medical attention as soon as possible. The treatment can help prevent liver failure. Do not wait for the symptoms of liver failure.

Some cases of acute liver failure do not have any obvious cause.

Risk factors

Risk factors for the acute liver failure include:

  • The fact of being a woman. The majority of people affected by acute liver failure are women.
  • Underlying disease. Many conditions, including viral hepatitis, metabolic diseases, autoimmune diseases, and cancer can increase the risk of acute liver failure.

Complications

Acute liver failure often causes complications, including:

  • Too much fluid in the brain, called cerebral edema. Too much fluid causes pressure to build up in the brain, which can lead to disorientation, severe mental confusion and seizures.
  • The bleeding and bleeding disorders. One of the failures of the liver cannot make enough clotting factors, which help the blood to clot. Bleeding in the gastrointestinal tract is common with this condition. It can be difficult to control.
  • Infections. People with acute liver failure are more prone to develop infections, particularly in the blood and in the respiratory and urinary tracts.
  • The renal failure. Kidney failure often occurs after liver failure, especially with an overdose of acetaminophen, the damage to both the liver and the kidneys.

Prevention

To reduce the risk of acute liver failure by taking care of your liver.

  • Follow the instructions of the drug. If you take acetaminophen or other medications, please consult the prospectus of the recommended dose, and not to take more than that. If you already have liver disease, ask your health care team if it is safe to take any amount of acetaminophen.
  • Tell your health care team about all your medications. Even without a prescription and herbal medicines may interact with prescription medications that you are taking.
  • Drink alcohol only in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Avoid risky behaviors. Get help if the illicit use of intravenous drugs. Do not share needles. The use of condoms during sex. If you have tattoos or body piercing, make sure that the shop you choose is clean and safe. Do not smoke.
  • Get vaccinated. If you have a chronic illness of the liver, a history of any type of hepatitis infection or an increased risk of hepatitis, talk with your health care team about the introduction of the vaccine against hepatitis B. the vaccine is also available for hepatitis A.
  • Be careful not to come into contact with other people's blood and body fluids. Accidental needle sticks or inadequate cleaning of blood or body fluids can spread hepatitis a virus. Share razors or toothbrushes can also spread the infection.
  • Do not eat mushrooms. It can be difficult to tell the difference between a poisonous mushroom is safe to eat.
  • Be careful with the spray. When you use an aerosol cleaner, make sure that the room is ventilated, or wear a mask. Taking similar measures of protection when spraying insecticides, fungicides, paints and other toxic chemicals. Carefully follow the instructions of the product.
  • Look at what you put on your skin. When using insecticides and other toxic chemicals, cover your skin with gloves, long sleeves, a hat and a mask.
  • Maintain a healthy weight. Obesity can cause a condition called nonalcoholic fatty liver disease (NAFLD), which now is called the metabolic dysfunction associated with the steatotic liver disease (MASLD). MASLD can lead to serious damage in the liver.

Diagnosis

Tests and procedures used to diagnose acute liver failure include:

  • Blood tests. Blood tests can show how well the liver works. A test of prothrombin time measures the time it takes for blood to clot. With acute liver failure, the blood does not clot as quickly as it should.
  • Imaging tests. A health professional may recommend an ultrasound exam to look for in the liver. Such tests can show damage in the liver and help to find the cause of the problems of the liver. A health professional may also recommend an abdominal computed tomography (CT) or magnetic resonance imaging (MRI) to look at the liver and blood vessels. These tests can look for certain causes of acute liver failure, such as the Budd-Chiari syndrome or tumors. They can be used if a problem is suspected and ultrasound test is not to find the problem.
  • The examination of liver tissue.A health professional may recommend the removal of a small piece of liver tissue, called a biopsy of the liver. In doing so, can help you to discover why the liver is failing. Since people with acute liver failure are at risk of bleeding during the biopsy, liver biopsy transjugular can be performed. This procedure involves making a small incision in the right side of the neck. A thin tube called a catheter is inserted into a vein in the neck, through the heart and into a vein exit the liver. A needle is then passed through the catheter to remove a sample of tissue from the liver.

The examination of liver tissue. A health professional may recommend the removal of a small piece of liver tissue, called a biopsy of the liver. In doing so, can help you to discover why the liver is failing.

Since people with acute liver failure are at risk of bleeding during the biopsy, liver biopsy transjugular can be performed. This procedure involves making a small incision in the right side of the neck. A thin tube called a catheter is inserted into a vein in the neck, through the heart and into a vein exit the liver. A needle is then passed through the catheter to remove a sample of tissue from the liver.

Treatment

People with acute liver failure, often treated in the intensive care unit of a hospital in a facility that can perform a liver transplant, if necessary. A health professional may attempt to treat the liver damage itself, but in many cases, the treatment consists in controlling the complications and give the liver time to heal.

Acute liver failure treatments may include:

  • Medications to counteract the poisoning. Acute liver failure caused by acetaminophen overdose is treated with a drug called acetylcysteine. This medicine can also help to treat other causes of acute liver failure. Mushrooms and other foodborne illnesses can also be treated with drugs that can reverse the effects of the toxin and can reduce the damage to the liver.
  • Liver transplant. When the acute liver failure can not be reversed, the only treatment that may be a liver transplant. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver from a donor.

A health professional also will typically work to the control of symptoms and try to avoid the complications caused by acute liver failure. The care may include:

  • Relieve painful pressure caused by excess fluid in the brain. The Brain edema caused by acute liver failure can increase the pressure in the brain. Medications can help reduce the accumulation of fluid in the brain.
  • Screening for infections. Your medical team may take samples of blood and urine every now and then to be tested for the infection. If your team suspects that you have an infection, you will receive medications to treat the infection.
  • The prevention of severe hemorrhage. Your health care team may give you medicines to reduce the risk of bleeding. If you lose a lot of blood, tests may be done to find the source of the blood loss. Blood transfusions may be necessary.
  • Provide nutritional support. If you are not able to eat, you may need supplements to treat nutritional deficiencies.

Future treatments

Scientists continue to research new treatments for the acute liver failure, especially those that may reduce or delay the need for a liver transplant. While a number of potential treatments are being explored, it is important to remember that the treatments are experimental and may not be available yet.

These treatments are among those who are being studied:

  • Artificial liver assist devices. A machine do the work of the liver, such as dialysis for help when the kidneys stop working. There are many different types of devices that are being studied. The research suggests that some, but not all, of the devices may improve survival. A well-controlled multicenter study demonstrated that a system, called liver support extracorporeal system, helped some people with acute liver failure survive without a transplant. The treatment is also called high-volume plasma exchange. However, more studies are needed for this therapy.
  • Hepatocyte transplantation. The transplant only the cells of the liver — not all of the body — can temporarily delay the need for a liver transplant. In some cases, in a short period of delay could lead to a full recovery. A shortage of good quality donor livers has limited the use of this treatment.
  • Auxiliary liver transplantation. This procedure involves removing a small piece of your liver and its replacement with a size similar to the graft. This allows to your own liver to regenerate without the need for immunosuppressive drugs. At this time, auxiliary liver transplant is a difficult procedure that needs further investigation.
  • Xenotransplantation. This type of transplant replaces the human liver with a liver of an animal or other species of origin. The doctors performed experimental liver transplantation the use of pork liver from several decades ago, but the results were disappointing. However, advances in the immune response and in transplantation medicine have led researchers to consider this new treatment. You can help provide support to people in hopes of a human liver transplant.

Preparing for your appointment

If a healthcare provider suspects that you have acute liver failure, it is likely that you will be admitted to the hospital for treatment. Most people with acute liver failure are treated in an intensive care unit.

What you can do

If you have been diagnosed with acute liver failure, here are some questions to ask your care team:

  • What made my acute liver failure?
  • It can be corrected?
  • If it can be reversed, my liver to heal completely?
  • What are the treatments?
  • I'm going to need a liver transplant?
  • What this hospital has a unit of liver transplantation?
  • Should I transfer to a hospital that performs a liver transplant?

What to expect from your doctor

Your health care team will ask you or your family questions to try to find the cause of your acute liver failure, including:

  • When did symptoms begin?
  • What prescription medications do you take?
  • What over-the-counter medicines that you take?
  • What herbal supplements do you take?
  • Does the use of illegal drugs?
  • You have had liver problems in the past?
  • Have you been diagnosed with hepatitis or jaundice?
  • Do you have a history of depression or thoughts of suicide?
  • How much alcohol do you drink?
  • Have you recently started taking new medications?
  • Do not take acetaminophen (Tylenol, others)? How much?
  • Can liver problems in your family?
Symptoms and treatment of the Acute liver failure