Prof.Dr. Sanjay Singh Negi
Director, HPB Surgery and Liver Transplantation
Digestive & Liver Care (Gastroenterology – GI Care)
BLK Super Speciality Hospital,New Delhi
(Visiting Professor -College of Medical Science,Bharatpur)
Around 30 million people suffer from liver disease and more than 8000 people undergo liver transplants in a year. Liver disease can be hereditary or caused by various factors, such as viral infection and alcohol use. In some cases, obesity is connected to liver damage. Over the years, the liver damage results in cirrhosis (scarring) leading to liver failure.
What is liver failure?
Liver failure happens when the liver fails to perform normal activities. It occurs when a huge portion of the liver is damaged because of liver disorders. The liver is responsible for producing enzymes and filtering blood. The general symptoms of liver failure include a decrease in appetite, blood in stool, jaundice, swelling of the feet, nausea, etc..
What causes liver failure?
There are various factors that can cause liver failure. Certain diseases and conditions, like Hepatitis B and C, non-alcoholic fatty liver diseases, and hemochromatosis results in liver diseases. In some cases, cirrhosis results in chronic liver failure.
Cirrhosis is scarring of the liver which is caused by chronic injury to the liver, excessive intake of alcohol, or chronic hepatitis infection. When the healthy liver tissue is replaced with scar tissue, it loses the ability to function.
Acute liver failure is caused by
• Viral infections, such as hepatitis B and C.
• The overuse of drugs, like acetaminophen and certain antibiotics.
• Metabolic or vascular disorders, like Wilson disease and autoimmune hepatitis.
Chronic liver failure is caused by:
• Chronic liver failure takes time to develop, and it can be months or years before the person notices the symptoms.
• Prolonged use of alcohol
• Cirrhosis results in chronic liver failure.
Liver failure signs and symptoms
One of the earliest symptoms of liver failure is jaundice or yellowing of the skin and eyes due to build of bilirubin. A healthy liver filter bilirubin out of the blood but a damaged or unhealthy liver loses this ability. The other symptoms of liver failure include:
• Easy bleeding or bruising
• Fluid buildup in the abdominal cavity called ascites
• Impaired brain function or mental confusion
Risk factors of liver failure:
Certain factors result in liver diseases, such as excess alcohol intake, sharing needles while injecting drugs, diabetes, obesity, and much more. Liver disease complications may vary depending upon the liver problems. Some untreated liver diseases might progress to liver failure, which could be a life-threatening condition.
How is liver failure diagnosed?
Liver failure could be difficult to diagnose in an early stage because there are no symptoms. A blood test and physical exam can help in diagnosing a liver disorder. Some signs include mental confusion, jaundice, coagulopathy (related to blood clotting) and liver enzymes level increases quickly.
Treatment for liver failure:
The treatment for liver failure depends upon the disease condition and some of them are treatable either by medication or liver transplant.
Some patients will get better when they receive treatment for the symptoms. A majority of patients’ condition is caused by virus infection, which might get better on their own. In such cases, the liver will be able to reform into a healthy organ.
When liver failure is caused by any health condition, such as cardiovascular disease or diabetes, these can be treated using medications. Certain medicines might be able to reverse liver failure conditions if the medications are given at an early stage.
A majority of the patients need a liver transplant to restore liver functions. However, the liver transplantation may not be advisable or recommended for people with liver failure.