Acute liver failure: what are its symptoms, causes and treatment

Acute liver failure is the rapid (days to weeks) loss of liver function, usually in a person who does not have pre-existing liver disease. Most often, the cause is a hepatitis virus or medications like acetaminophen. Acute liver failure is less common than chronic liver failure, which develops more slowly.

Acute liver failure, also known as fulminant liver failure, can cause serious complications, including bleeding and increased pressure on the brain. This is a medical emergency that requires hospitalization.

Depending on the cause, acute liver failure can sometimes be reversed with treatment. However, in many situations, a liver transplant may be the only cure.

Symptoms

Signs and symptoms of acute liver failure may include: Yellowing of the skin and eyeballs (jaundice) Pain in the upper right part of the abdomen Swelling in the belly (ascites) Nausea Vomiting Feeling generally unwell Disorientation or confusion Drowsiness Breath may have a sweet or musty odor Tremors

When to see the doctor

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

Diagnostic

People with acute liver failure often receive treatment in a hospital intensive care unit in a facility equipped to perform a liver transplant, if needed. Your health care provider may try to treat liver damage themselves, but in many cases treatment involves managing complications and giving the liver time to heal.

Treatments for acute liver failure may include: Drugs to reverse poisoning. Acute liver failure caused by an overdose of acetaminophen is treated with a drug called acetylcysteine. This medication may also help treat other causes of acute liver failure. Mushroom and other substance poisoning can also be treated with medications that reverse the effects of the toxin and reduce liver damage. Liver transplant. When acute liver failure is irreversible, the only treatment may be a liver transplant. In a liver transplant, the surgeon removes the damaged liver and replaces it with a healthy liver from a donor.

Your health care provider will also work to manage your symptoms and try to avoid complications caused by acute liver failure. Medical care may include the following: Release of pressure caused by excess fluid in the brain. Cerebral edema caused by acute liver failure can increase pressure in your brain. Medications can help reduce fluid buildup in your brain. Infection screening tests The medical team will take blood and urine samples from time to time to check for infection. If your health care provider suspects you have an infection, you will be given medicine to treat it. Prevention of serious bleeding. Your health care provider may give you medicine to reduce the risk of bleeding. If you are losing a lot of blood, tests may be done to find the source of the loss. You may need blood transfusions. Nutritional support. If you can’t eat, you may need supplements to treat nutritional deficiencies.

future treatments

Scientists continue to search for new treatments for acute liver failure, especially those that may reduce or delay the need for a liver transplant. Although there are several possible future treatments in development, it is important to remember that they are experimental and may not yet be available.

The treatments studied are as follows: Artificial liver assist devices . A machine would do the work of the liver, the same way dialysis does when the kidneys stop working. There are many types of devices under consideration. Research shows that some devices, but not all, can improve survival. A well-controlled, multicenter trial showed that a system, called an extracorporeal liver support system, helped some people with acute liver failure survive without a transplant. The treatment is also known as high volume plasma exchange. However, further studies are needed for this therapy. hepatocyte transplant . Transplanting only the liver cells, not the whole organ, can temporarily delay the need for a liver transplant. In some cases, this could allow full recovery. This treatment is limited by the scarcity of good quality donated livers. Auxiliary liver transplant . This procedure involves removing a small portion of the liver and replacing it with a similar sized graft. This allows your own liver to regenerate without the need for immunosuppressive drugs. At present, auxiliary liver transplantation is a difficult procedure that requires more evaluation time. Xenotransplantation . This type of transplant replaces the human liver with a liver of animal or non-human origin. Doctors performed experimental liver transplants using pig livers decades ago, but the results were disappointing. However, advances in immunological medicine and transplantation have led researchers to reconsider this treatment. This can help provide support for people awaiting a human liver transplant.