Liver failure occurs when the liver is damaged and fails to function properly. This condition impacts all the vital functions of the liver including production of bile for digestion of food and clearing toxic substances from the blood. It can be a life-threatening condition that requires urgent clinical care. Mostly, liver failure is the end stage of many liver diseases and develops slowly over a period of many years. But in some conditions, liver failure may happen suddenly in a short time (a day or more).
There are two types of liver failure
Acute liver failure: This happens when the liver stops functioning quickly, within days or weeks. It can be difficult to detect at first as most people with acute liver failure don’t have any type of liver disease or symptoms before this.
Chronic liver failure: This occurs gradually over a period of time, mostly years. As the damage to the liver builds up, it stops working and performing important functions.
The early signs of chronic liver failure are mostly similar to those of liver diseases. This makes it difficult to diagnose liver failure first. Chronic liver failure early symptoms include:
- Fatigue or tiredness
- Loss of appetite
- Feeling of nausea or vomiting
- Abdominal discomfort or pain
Some symptoms of the advanced stages of chronic liver failure that can indicate need of immediate care include:
- Jaundice – yellowing of the skin and eyes
- Bruising or bleeding easily
- Confusion or feeling disoriented (hepatic encephalopathy)
- Swelling due to buildup of fluid in the abdomen, arms, or legs
- Darkening of urine
- A severe itching on skin
The cause of liver failure in a person depends on whether it is acute or chronic.
Causes of acute liver failure
As the acute liver failure occurs rapidly, it can be caused by a number of factors. Some of the possible causes are:
- Viral infections: Hepatitis A, B, or E, Epstein-Barr virus, cytomegalovirus, and herpes simplex virus
- Acetaminophen (Tylenol) overdose can damage liver
- Reaction to certain prescription medications including antibiotics, NSAIDs, or anti-epileptic drugs
- Reaction to certain herbal supplements, including ma huang and kava kava
- Wilson’s disease, a metabolic condition in which the body is unable to remove copper. The build up of copper may cause damage to the liver.
- Autoimmune hepatitis: Body’s immune system attacks the liver cells
- Budd-Chiari syndrome: a condition that affects the blood vessels of the liver
- Exposure to toxins, such as in poisonous wild mushrooms or industrial chemicals
Causes of chronic liver failure
Chronic liver failure develops slowly over time. It can lead to cirrhosis, in which there are a number of scar tissues on the liver. This prevents the liver from functioning properly.
Some examples of possible causes of chronic liver failure include:
- A chronic viral infection of hepatitis B or C
- Alcoholic liver disease: long-term alcohol abuse can lead to cirrhosis
- Nonalcoholic fatty liver disease: In this, extra fat cells build up in the liver. It often affects people who are obese or have high cholesterol.
- Autoimmune hepatitis
- Diseases that affect the bile ducts, such as primary biliary cholangitis
- Hemochromatosis, a genetic disorder which causes the body to absorb and accumulate too much iron. The build up of iron in the liver can lead to cirrhosis.
Liver Disease stages
- Stage 1 – Inflammation: It is an early stage. The liver will be enlarged or inflamed. It could also be tender or may not even bother at all.
- Stage 2 – Fibrosis/scarring: If the inflammation is left untreated, it causes scarring of the tissue. As the scar tissue replaces healthy tissue in the liver, the blood flow is stopped. This keeps the healthy parts from functioning properly and makes them work harder.
- Stage 3 – Cirrhosis: As the scar tissue takes over most healthy tissues in the liver, a large part of the organ is unable to function. It prevents the liver from working well, or even working at all.
- Stage 4 – End-stage liver failure/disease: At this stage, liver function is completely deteriorated, to a point where it can not be reversed. This includes a variety of conditions, such as swollen liver, internal bleeding, loss of kidney function, fluid build up in the abdomen, and lung problems.
A liver transplant is the only permanent treatment for end-stage liver failure. In this, the damaged liver of the patient is replaced with a portion of or whole healthy liver from a deceased or living donor. The liver has a unique ability to regenerate and regrow, making living donor liver transplants possible. A part of the liver, 30-70%, can be retrieved from a healthy matched donor and transplanted in the patient after removing their damaged one. The parts of the liver in both recipient and donor grows to full size and resume normal functions in some time. It can be a life-saving procedure for many and can increase a person’s life span by many years. The excellent liver transplant survival rate makes it a recommended surgery in many cases of end-stage liver failure.