Liver Failure

Dr. Rajalakshmi VK (AIIMS)MBBS

December 10, 2018

March 06, 2020

Liver Failure
Liver Failure

What is liver failure?

The liver executes numerous functions. It filters blood, converts food to usable energy and has a defensive function. When the liver cannot perform some or all of these functions, the condition is called liver failure.

What are its main signs and symptoms?

Liver failure is of two main types: acute and chronic.

  • Acute liver failure occurs with a sudden onset- in a few days or weeks. Symptoms include:
    • Yellowish tinge of skin and eyes (jaundice)
    • Nausea and vomiting
    • Fatigue and confusion
    • Severe liver failure can cause brain damage, called cerebral encephalopathy causing loss of orientation of space and time
  • Chronic liver failure can take months or even years to show any symptoms. In addition to symptoms of acute liver failure, other signs seen are:
    • Fluid retention in the legs causing swelling
    • Fluid accumulation in the abdomen (ascites)
    • Weight loss
    • Spontaneous bleeding

A third type, called acute-on-chronic liver failure, has recently been recognised, where chronic liver failure is exaggerated due to sudden worsening of liver function.

What are its main causes?

  • Causes of acute liver failure are:
    • Side effects of some medications like antiepileptics
    • Viral infections like hepatitis B or hepatitis C infection
    • Consuming poisonous substances
    • Sometimes, cancer can also cause liver failure
    • Herbal preparations
  • Causes of chronic liver failure are:
    • Long-term alcoholism
    • Hepatic cirrhosis
    • Autoimmune diseases like autoimmune hepatitis
    • Genetic diseases
    • Malnourishment

How is it diagnosed and treated?

When you approach a doctor with the above symptoms, he/she will look for a history of medications taken, alcohol consumption and genetic illnesses.

  • A simple blood test along with a biopsy can help diagnose a liver disorder.
  • Abdominal ultrasound, CT scan and MRI are some other tests that help the physician assess the health of the liver.

Treatment includes treating the underlying cause and correcting symptoms to stabilize the patient.

  • If a medicine has caused hepatic failure, the medicine is substituted with other drugs to reverse its effects.
  • If only a part of the liver is affected, that part can be removed so the liver can regenerate.
  • If liver failure is due to an irreversible cause, a liver transplant is the only alternative.
  • Diet and lifestyle changes are also required to supplement treatment.


  1. Science Direct (Elsevier) [Internet]; Acute liver failure
  2. American Family Physician. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. University of Michigan Medical School, Ann Arbor,Michigan; September 1, 2006, Volume 74, Number 5
  3. Grek A, Arasi L. Acute Liver Failure.. AACN Adv Crit Care. 2016 Oct;27(4):420-429. PMID: 27959298
  4. Shah NJ, John S. Acute and Chronic Liver Failure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
  5. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Liver Diseases

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