Key takeaways
- Liver failure occurs when the liver loses or has lost all of its function. It is a life threatening condition that requires immediate medical care.
- Stages of liver diseases include inflammation, fibrosis, cirrhosis, and end stage liver disease (ESLD).
- In the early stages, people may have no symptoms. Earlier diagnosis and treatment can help improve a person’s outlook and survival rate.
The liver has many functions. The most important of these include producing bile, storing glycogen, and removing toxins from the bloodstream.
Liver failure can be chronic or acute. In people with acute liver failure, the liver rapidly loses its function. In those with chronic liver failure, the liver loses function over a longer period.
Liver disease refers to any condition that causes damage to the liver and may affect its function. Liver failure is the term for the liver losing some or all functionality. Liver disease
According to the American Liver Foundation, liver disease may go through the following stages of progression that can ultimately lead to liver failure.
Stage 1: Inflammation
During the early stages of liver disease, people may experience liver inflammation.
It is common not to feel discomfort or other symptoms during the earlier stages of liver disease. However, without treatment, the inflammation may remain, and it can start to cause permanent damage to the liver.
Stage 2: Fibrosis
Without treatment, scarring may start to develop on the inflamed liver. Excessive buildup of scar tissue on the liver is called liver fibrosis.
Over time, excess scar tissue replaces the liver tissue. As scar tissue builds up, the liver may not function as well as it previously did. Additionally, the scar tissue can stop blood from flowing through the liver.
If someone seeks medical attention and treatment at this stage, the liver may still be able to heal.
Stage 3: Cirrhosis
At this stage, hard scar tissue replaces the liver’s soft, regular tissue. At this stage, people may begin to notice symptoms.
Cirrhosis can lead to complications, including malnutrition and liver cancer.
Without treatment, cirrhosis can worsen. As a result, the liver may stop working properly or at all.
Generally, once cirrhosis is present, it is not reversible. However, in certain cases of compensated cirrhosis, healthcare professionals may be able to identify the cause of cirrhosis and improve the degree of scarring.
Key terms explained
- Compensated cirrhosis: In which the liver has scarring but still functions.
- Decompensated cirrhosis: In which the liver has more extensive scarring and no longer functions as it should.
Stage 4: End stage liver disease (ESLD)
At this point, a person’s liver function has deteriorated to such an extent that, unless they undergo a liver transplant, their condition will be fatal.
Some doctors may also refer to ESLD as chronic liver failure. The average survival rate of people with ESLD depends on various factors, including organ donor availability, complications, and active substance use.
People who develop ascites, a buildup of fluid in the abdomen, have a median survival rate of 6 months if it does not respond to treatment.
ESLD can also lead to complications, such as hepatic encephalopathy, which affects brain function.
The potential causes of acute and chronic liver failure vary. In some cases, doctors do not know the cause.
Acute liver failure
Possible causes of acute liver failure
- Drug use: Certain medications and substances, such as acetaminophen (Tylenol), may lead to acute liver failure.
- Viral causes: Certain viral infections, such as viral hepatitis or the Epstein-Barr virus, can lead to acute liver failure.
- Immune or metabolic diseases: This can include conditions such as Wilson’s disease, a genetic condition in which large amounts of copper accumulate in the body.
- Pregnancy-related conditions: Conditions that can occur due to pregnancy, such as acute fatty liver of pregnancy, can lead to acute liver failure.
- Other conditions: Other health conditions, such as Budd-Chiari syndrome, in which the veins of the liver narrow, can lead to acute liver failure.
Chronic liver failure
Potential causes of chronic liver failure
- Alcohol-associated liver disease: This results from excessive alcohol over a long period. This is the most common cause of chronic liver disease.
- Metabolic dysfunction-associated steatotic liver disease: This umbrella term encompasses a range of conditions that cause high levels of fat to accumulate in the liver.
- Chronic viral hepatitis: Chronic infections with hepatitis B, C, or D can lead to chronic liver disease.
- Genetic causes: Certain genetic conditions, such as Wilson’s disease, or genetic irregularities can cause chronic liver disease. A deficiency in Alpha-1 antitrypsin is the most common cause in children.
- Autoimmune causes: Certain autoimmune diseases, such as autoimmune hepatitis or primary biliary cholangitis, a progressive liver disease, can cause chronic liver failure.
- Other causes: Substance use and other health conditions, such as Budd-Chiari syndrome, can cause chronic liver failure.
Acute liver failure is a medical emergency, and a person
Chronic liver diseases progress more slowly than acute ones. Initially, a person may not experience any symptoms or symptoms
People with the more advanced stages of liver disease may have the following symptoms:
- jaundice
- confusion
- easy bruising or bleeding
- swollen legs or abdomen
- dark urine
- itching skin
- vomiting blood
Treatment for liver disease will vary depending on the stage and underlying cause of the disease.
If someone receives treatment at the inflammation or fibrosis stage, the liver may be able to reverse the damage. However, treatment for the later stages of liver disease can only stop it from worsening, with the aim of prolonging life.
Possible treatments for people who experience chronic or acute liver disease include:
- Antiviral medications: If the cause of the liver disease is viral hepatitis, a person may require antiviral medications.
- Immunosuppressing medication: This type of medication is necessary for people experiencing autoimmune hepatitis.
- Lifestyle choices: When the cause of the liver disease is related to alcohol or obesity, a doctor may advise the person to stop drinking or try to lose weight.
- Liver transplant: In cases of ESLD, a person may require a liver transplant. This procedure is extremely complex and relies on the availability of a suitable donor.
A person can minimize their risk of developing liver disease by:
- reaching or maintaining a moderate weight
- avoiding excessive alcohol consumption
- completing the hepatitis vaccination schedule
- following the dosages that a doctor recommends, if taking medication
- engaging in regular physical activity
If someone seeks medical treatment during the early stages of liver disease and adopts a healthy lifestyle, their liver might be able to heal from any previous damage.
However, once a person is in the cirrhosis stage of liver disease, in most cases, the damage becomes irreversible. Treatment during this stage is usually to stop the damage from worsening and prolong a person’s life.
A 2022 review suggests that people with compensated cirrhosis live for a median of less than 12 years, while people with decompensated cirrhosis live for an average of around two years.
Factors such as treatment and complications can affect survival rates. Seeking treatment can help to prolong a person’s survival even with later stages of liver disease.
Liver failure occurs when the liver is no longer able to function as it should. It can occur rapidly in people with no preexisting liver disease, or it may develop over a long period.
Treatment options vary depending on the cause and stage of the disease.
A person can reduce the risk of developing liver diseases that may lead to liver failure by making lifestyle adjustments and getting certain vaccinations.