Liver failure

From ArticleWorld

Liver failure is the final stage of severe liver dysfunction to the point where the afflicted person develops encephalopathy (brain dysfunction) from elevated ammonia levels that are not properly processed by the liver. Liver failure is considered a life-threatening condition.

Causes

Liver failure can be an acute event or the result of a chronic process. Acute causes include acetaminophen toxicity, such as in an overdose situation. In some cases, a person can take excessive doses of acetaminophen over a period of time and can develop liver toxicity or failure as a result.

Another cause of liver failure is viral hepatitis. Acute hepatitis A can rarely result in liver failure. Infections with hepatitis B and C viruses are generally chronic and can gradually diminish liver function. Cancers of the liver or cancers that metastasize to the liver can become so invasive that the liver fails. Cancers that impact the blood flow to or from the liver can quickly impair liver function.

Cirrhosis or scarring of the liver is generally a phenomenon of alcoholism; however, some genetic and non-alcoholic conditions can lead to cirrhosis. Often the liver dysfunction is gradual and only becomes noticeable when the individual becomes yellow or takes on abdominal fluid.

Signs and Symptoms

The hallmark of liver failure that distinguishes it from liver dysfunction is the finding of encephalopathy or brain dysfunction. The individual is often somnolent and can become comatose. Other findings of liver failure are jaundice or yellowing of the skin from excessive bilirubin in the blood. The liver is supposed to break down red blood cells and rid the body of bilirubin, a metabolite, by mixing it in with bile salts to make bile.

While patients with liver failure are often malnourished and have thin arms and legs, their bellies are full of fluid, a condition caused ascites. This is caused by the liver not being able to take the blood delivered to it from the intestines via the portal vein. The pressure in the portal vein increases and excess fluid is leaked out into the abdominal cavity.

The individual with liver failure also have the inability to make the necessary factors for coagulating blood. They can develop bleeding complications as a result.

Treatment

Treatment of liver failure is first directed at correcting the underlying cause. Unfortunately, this is not often possible. Patients must remain on a low protein, low salt diet. Lactulose is sometimes given orally to bring down ammonia levels. Unless an individual resolves spontaneously, a liver transplant is likely the best option as the mortality rate for liver failure is between 60 and 75%.