Liver Failure – Acute, Chronic, Symptoms, and Complications of Liver Failure

Liver insufficiency refers to the deterioration of liver function, ultimately leading to liver failure. As the condition progresses, some of the liver’s functions begin to fail, while others remain intact.

In the end stage of liver insufficiency, all liver functions are affected.

The liver is the body’s central metabolic organ and is located above the right rib cage.

The main functions of the liver are

• the production of bile,
• detoxification,
• energy storage and supply,
• metabolism, and
• the production of creatine.

The liver is resistant to environmental toxins and has a high capacity for self-healing. Nevertheless,

• today’s lifestyle,
• potent medications,
• obesity caused by poor diet, and
• the global spread of pathogens

can lead to liver disease.

The location of the liver in the human body © nerthuz | AdobeStock

Liver failure is characterized by

• deficient protein synthesis,
• insufficient detoxification function, and
• reduced bile production

and is always life-threatening. The course of liver failure is usually chronic and leads to cirrhosis of the liver.

One method that supports the liver in detoxifying the blood is, for example, liver dialysis.

Liver failure often develops as a result of

• adverse drug reactions,
• alcohol abuse,
• diabetes, or
• obesity.

Other causes include inflammation of the bile ducts (cholangitis) or inflammation of the liver tissue caused by hepatitis viruses B, C, and D.

Congenital liver diseases, such as

• hemochromatosis (iron storage disease),
• alpha-1 antitrypsin deficiency,
• cystic fibrosis, or
• forms of porphyria

are responsible for the deterioration of liver function.

Liver failure is characterized by

• icterus (jaundice),
• hepatic encephalopathy,
• hepatorenal syndrome (kidney failure resulting from liver failure),
• coagulation disorders,
• hypoalbuminemia, and
• endocrine disorders

.

Liver function can be affected to varying degrees by degenerative processes. The classification of liver failure into stages takes into account the liver’s metabolic capacity, its excretory function, and the effects on circulation.

In mild liver failure, only certain parts of the liver are affected. This impairment of liver function may manifest as mild jaundice or ascites.

In moderate liver failure, the entire liver is affected. Detoxification, energy storage, bile production, and metabolic functions are impaired. Severe liver failure marks the end stage of an acute or chronic liver disease.

To treat liver failure effectively, the underlying cause must be diagnosed. Liver failure is confirmed by

• selected laboratory test results,
• ultrasound examinations (sonography),
• computed tomography,
• magnetic resonance imaging, and
• possibly a liver biopsy.

Treatment of liver failure depends on the underlying condition. Liver dialysis detoxifies the blood and can lead to a short-term improvement in liver function. In particularly severe cases, a liver transplant may be considered.

What is liver failure?

Liver failure refers to the loss of liver function, ranging up to liver failure with severe impairment of vital liver functions. A distinction is made between acute, subacute, and chronic liver failure. Acute liver failure, in particular, is a life-threatening condition and is also referred to as ALF (acute liver failure).

What are the causes of acute liver failure?

Causes of acute liver failure include viral hepatitis, particularly hepatitis A or hepatitis B, a paracetamol overdose, and toxic substances such as Amanita phalloides. Sepsis, bacterial infections, or other possible causes can also lead to acute liver failure. Causes and risk factors should always be carefully investigated.

What are the symptoms of liver failure?

Typical symptoms of liver failure include icterus, jaundice, coagulopathy, and hepatic encephalopathy. People with acute liver failure may also experience kidney failure, bleeding, or ascites. Clinically, elevated transaminases and a loss of liver function are observed.

How is liver failure diagnosed?

The diagnosis of liver failure is based on laboratory values such as bilirubin and transaminases, a physical examination, and, if necessary, a liver biopsy. The key factor is the confirmation of acute liver failure without pre-existing cirrhosis. Patients with liver failure are often referred to a transplant center.

How is liver failure treated?

Treatment for liver failure depends on the underlying cause. In cases of acetaminophen poisoning, N-acetylcysteine is administered. Additional measures include supportive care, antibiotic therapy for infections, or antiviral therapy for hepatitis. In severe cases, a liver transplant is often the only definitive treatment for liver failure.