Liver failure

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Liver failure is the final stage of liver disease. Liver failure is divided into types depending on the rapidity of onset. Acute liver failure develops rapidly, but chronic liver failure may take months or years to develop. By definition, liver failure occurs when the liver is so diseased, and functioning so poorly, that encephalopathy is evident. Any progressive liver disease can result in liver failure; examples include: acetaminophen toxicity, cirrhosis, viral hepatitis, and metastatic cancer of the liver. Other signs of liver disease such as jaundice, ascites, fetor hepaticus, and failure of coagulation indicate that the liver is having trouble performing its normal physiological duties, but it is not termed liver failure until the mental status changes appear.

Treatment involves correcting any underlying cause, if this is possible. Even when the cause is identified and treated, the progression to complete liver failure may be irreversible. In this case, steps are taken to slow down the decline of liver function. The patient's diet is restricted. Protein consumption is kept at optimal levels. If it is too high, it can cause brain dysfunction, but too little can cause weight loss. Alcohol must be completely avoided. Keeping sodium consumption down helps to prevent ascites, the accumulation of fluid in the abdomen. Liver dialysis is evolving as a treatment modality and is pending approval by regulators in the USA. Liver transplantation is the definitive treatment for liver failure, but is not an option for all patients and the supply of livers is limited. Medications, such as lactulose, can be given to relieve the symptoms of liver failure.