Liver Failure

Liver failure occurs when large parts of the liver become damaged beyond repair and the liver is no longer able to function.

Liver failure is a life-threatening condition that demands urgent medical care. Most often, liver failure occurs gradually and over many years. However, a more rare condition known as acute liver failure occurs rapidly (in as little as 48 hours) and can be difficult to detect initially.

What Causes Liver Failure?

The most common causes of chronic liver failure (where the liver fails over months to years) include:

The causes of acute liver failure, when the liver fails rapidly, however, are often different. These include:

  • Acetaminophen (Tylenol) overdose
  • Viruses including hepatitis A, B and C (especially in children)
  • Reactions to certain prescription and herbal medications
  • Ingestion of poisonous wild mushrooms


What Are the Symptoms of Liver Failure?

The initial symptoms of liver failure are often ones that can be due to any number or conditions. Because of this, liver failure may be initially difficult to diagnose. Early symptoms include:

  • Nausea
  • Loss of appetite
  • Fatigue
  • Diarrhea

However, as liver failure progresses, the symptoms become more serious, requiring urgent care. These symptoms include:

  • Jaundice
  • Bleeding easily
  • Swollen abdomen
  • Mental disorientation or confusion (known as hepatic encephalopathy)
  • Sleepiness
  • Coma


How Is Liver Failure Treated?

If detected early enough, acute liver failure caused by an overdose of acetaminophen can sometimes be treated and its effects reversed. Likewise, if a virus causes liver failure, supportive care can be given at a hospital to treat the symptoms until the virus runs it course. In these cases, the liver will sometimes recover on its own.

For liver failure that is the result of long-term deterioration, the initial treatment goal may be to save whatever part of the liver is still functioning. If this is not possible, then a liver transplant is required. Fortunately, liver transplant is a common procedure that is often successful. However, even if you are considered a suitable candidate, finding a donor organ may prove too long. Today, there is an option to prolong your life during the search for a new liver – liver dialysis.

What Does Liver Dialysis Involve?

Liver dialysis is used as a bridge to liver transplantation for some patients with acute liver failure to support him/her through his/her liver failure until transplantation can be performed. Patients have been treated even up to one month while waiting for suitable living donors.

Liver dialysis is performed in the ICU in our dedicated Parkway Asian Transplant Unit, using a non-biological liver dialysis device known as the Molecular adsorbing re-circulating system (MARS™). It is the most commonly used device and it comes as an intermittent device or continuous device. Its charcoal-based system adsorbs the toxins, providing a detoxifying function without any contribution of the normal liver synthetic function. It may be coupled with a plasma separator and there may also be an albumin dialysate. The system usually has some way of trying to renew the cartridges to prolong its lifespan. This device has been utilised extensively at our centre for several years.

How Can Liver Failure Be Prevented?

The best way to prevent liver failure is to limit your risk of developing cirrhosis or hepatitis. Here are some tips to help prevent these conditions:

  • Get a hepatitis vaccine or an immunoglobulin shot to prevent hepatitis A or B
  • Eat a proper diet from all of the food groups
  • Drink alcohol in moderation. Avoid alcohol when you are taking acetaminophen (Tylenol)
  • Practice proper hygiene. Since germs are commonly spread by hands, be sure to wash your hands thoroughly after you use the bathroom. Also wash your hands before you touch any food.
  • Don’t handle any blood or blood products
  • Don’t share any personal toiletry items, including toothbrushes and razors
  • If you get a tattoo or a body piercing, make sure the conditions are sanitary and all equipment is aseptic (free of disease-causing microorganisms)
  • Be sure to use protection (condoms) when having sex
  • If you use illegal intravenous drugs, don’t share needles with anyone.