Liver failure

Liver failure occurs when the liver doesn't work properly as it should. The liver removes toxins from the body's blood supply, maintains healthy blood sugar levels, regulates blood clotting, and performs hundreds of other vital functions.

Liver failure can be sudden (acute liver failure) or progressive (chronic liver failure). Recently, a third form of liver failure known as **acute-on-chronic liver failure** (**ACLF**) is increasingly being recognized.

## Symptoms

The symptoms of liver failure include:

* Nausea and vomiting
* Loss of appetite
* Diarrhea
* Vomiting blood
* Blood in the stool
* Fatigue and weakness
* Tiredness
* Abdominal pain
* Jaundice (yellowing of your skin and eyes).
* Confusion, memory loss, and other memory problems
* Fluid buildup in your abdomen, arms, and legs
* Fainting
* Loss of consciousness

Acute (sudden) liver failure also causes bleeding, changes in mental status, musty or sweet breath odor, and movement problems.

## Causes and risk factors

Many different diseases and conditions cause liver failure, including Hepatitis B and C, non-alcohol related fatty liver disease, alcohol abuse and hemochromatosis. The causes of liver failure include:

### Causes of chronic liver failure

In many cases, chronic liver failure results from cirrhosis. Cirrhosis is the scarring of your liver from repeated or long-lasting injury, such as from drinking alcohol excessively over a long period of time or chronic hepatitis infection. As scar tissue replaces healthy liver tissue, yourliver loses its ability to function.

### Causes of acute liver failure

Acute liver failure is most often caused by:

* Infections involving the liver, such as Hepatitis B.
* The overuse of certain drugs or toxins, like acetaminophen (Tylenol), and the use of other medications (including certain antibiotics, antidepressants, anti-seizure medications, man-made hormones and antifungal drugs) and herbs (green tea extract and kava).
* Metabolic (biologic) or vascular (vessels that carry fluids, such as arteries) disorders, such as Wilson disease and autoimmune hepatitis, can cause acute liver failure.

## Treatment

Liver disease and liver failure are usually treated by specialists called hepatologists. Treatment of liver failure depends on whether it is acute or chronic.

For chronic liver failure, treatment includes changes to your diet and lifestyle, including:

* Avoiding alcohol or medications that can harm your liver.
* Eating less of certain foods, including red meat, cheese and eggs.
* Weight loss and management of metabolic risk factors, including high blood pressure and diabetes.
* Cutting down on salt in your diet (including not adding salt to food).

For acute (sudden) liver failure, treatment includes:

* Intravenous (IV) fluids to maintain blood pressure.
* Medications such as laxatives or enemas to help flush toxins (poisons) out.
* Blood glucose (sugar) monitoring. Your provider will give you glucose if your blood sugar drops.

You may also receive a blood transfusion if you are bleeding excessively, or a breathing tube to help you breathe.

In both acute and chronic liver failure, your doctor may recommend a liver transplant. Before transplantation, doctors thoroughly screen transplant candidates to make sure a new organ might help them before placing them on organ waiting lists. During the transplantation surgery, a healthy liver from a living or deceased donor replaces a damaged or diseased liver. Some transplant centers are able to replace a damaged liver with a portion of a healthy liver because the liver can regenerate, or grow back.