Liver Failure

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is liver failure?

Liver failure is a life-threatening condition in which there is a severe deterioration of liver function. The liver is a vital organ located in the right upper area of your abdomen under the ribs. Liver failure is caused by liver damage, which makes it difficult or impossible for the liver to function normally in processes that are critical to life and your overall health including:

  • Blood clotting

  • Clearing the blood of toxins

  • Fighting infection

  • Making bile that assists with digestion

  • Metabolizing medications and other substances

  • Producing proteins, enzymes, and healthy blood

  • Removing waste

  • Storing vitamins, minerals and energy

There are two general types of liver failure:

  • Acute liver failure is a failure of liver function that occurs suddenly due to such conditions as an overdose of acetaminophen (Tylenol) or ingestion of toxic substances. 

  • Chronic liver failure is a deterioration of liver function that occurs over a long period of time, generally months to years. Chronic liver failure is the most common form of liver failure and is generally due to long-term liver diseases, such as cirrhosis of the liver and hemochromatosis.

Symptoms of early liver failure can be vague and similar to many other less serious diseases, such as chronic fatigue syndrome or viral gastroenteritis. A hallmark symptom of advancing liver failure is jaundice, a yellowing of the skin and whites of the eyes.

In some cases of acute liver failure, rapid diagnosis and treatment may reverse the condition. However, once permanent liver damage has occurred due to either acute or chronic liver damage, it cannot be reversed or cured. Patient compliance with a good treatment plan may be able to slow or stop progression of liver damage and minimize complications.

Liver failure is a life-threatening condition that is often fatal because it drastically affects the liver’s ability to function normally. Seek prompt medical care if you have a history of chronic disease, such as hepatitis, congestive heart failure, or cirrhosis of the liver, and unexplained symptoms, such as nausea, fatigue, diarrhea or weakness. In addition, if you have any form of liver disease or liver failure, do not take any supplements, over-the-counter medications or prescription drugs without consulting your health care provider. This is because the liver may not be able to clear the drugs from the body, resulting in dangerous, toxic levels of chemicals or and other harmful substances in the body.

Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of acute or advanced chronic liver failure, such as shakiness, jaundice, confusion, shortness of breath, abdominal swelling, or a change in consciousness or alertness. You should also seek immediate medical care (call 911) if you, or someone you are with, have overdosed on a drug or ingested a toxic substance.

What are the symptoms of liver failure?

Early symptoms of liver failure are often not specific and may be confused with symptoms of many other conditions, such as indigestion, viral gastroenteritis, or chronic fatigue syndrome. Early symptoms may include:

Serious symptoms that might indicate a life-threatening condition

Symptoms of advanced liver failure can indicate the development of serious complications, such as portal hypertension or esophageal varices. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:

  • Ascites (buildup of fluid and swelling in the abdomen)

  • Bleeding, such as vomiting blood or severe rectal bleeding

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Jaundice (yellowing of the skin and whites of the eyes)

  • Muscle tremors or shakiness

  • Shortness of breath or difficulty breathing

What causes liver failure?

Liver failure is due to underlying liver diseases that often cause progressive damage to the liver. Liver disease generally begins with inflammation and enlargement of the liver, which may be reversed with medical treatment in some cases. Left untreated, liver inflammation leads to fibrosis (scarring) of the liver tissue that progresses and ultimately replaces healthy liver tissue. Scarred liver tissue cannot function normally, but prompt treatment may still reverse damage in some cases.

Scarred liver tissue that is not treated progresses to cirrhosis, a condition in which the liver is permanently damaged. If advancement of cirrhosis is not slowed or stopped, large areas of the liver will no longer function, causing liver failure.

Underlying diseases, disorders and conditions that can cause liver failure include:

  • Alcohol abuse

  • Autoimmune hepatitis (form of hepatitis in which the immune system attacks the liver)

  • Biliary atresia and secondary biliary cirrhosis (conditions that block bile ducts, leading to bile buildup in the liver and liver damage)

  • Chronic hepatitis B or C

  • Congestive heart failure

  • Cystic fibrosis (inherited disease that causes a buildup of mucus in the liver, lungs and other organs)

  • Glycogen storage diseases

  • Hemochromatosis (excessive level of iron in the body that causes liver damage)

  • Malnutrition

  • Overdose of certain drugs, such as acetaminophen (Tylenol)

  • Poisoning or toxic exposure, such as ingesting poisonous mushrooms or arsenic exposure

  • Severe acute hepatitis A

  • Wilson’s disease (inherited disease that causes excessive retention of copper)

What are the risk factors for liver failure?

A number of factors increase the risk of developing liver disease, which can lead to liver failure. Risk factors include:

  • Alcoholism

  • Coronary artery disease (due to atherosclerosis or hardening of the arteries, or other causes)

  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

  • Exposure to certain toxins, such as arsenic

  • Exposure to hepatitis

  • High triglyceride levels in the blood

  • Long-term treatment with corticosteroids

  • Obesity

Reducing your risk of liver failure

Not all people who are at risk for liver failure will develop the condition. However, you can lower your risk of developing liver failure by:

  • Avoiding risk factors for hepatitis, such as having unprotected sex with more than one partner or sharing needles for tattooing or drug use

  • Not drinking alcohol or limiting alcohol intake to one drink per day for a woman and two drinks per day for a man

  • Seeking regular medical care and following your treatment plan for chronic diseases and conditions, such as diabetes, obesity, high cholesterol, and coronary artery disease

How is liver failure treated?

Scar tissue formed in the liver due to advanced liver disease, which causes liver failure, is permanent. The goal of treatment is to stop or slow the progression of damage to the liver and minimize and quickly treat any other complications and coexisting conditions, such as portal hypertension and hemorrhage. Treatment plans include a multifaceted and individualized approach that varies depending on the underlying cause of liver disease and liver failure. For example:

  • Treatment of alcoholism includes abstaining from alcohol, which often requires participation in an alcohol treatment program.

  • Treatment of hepatitis may include corticosteroid drugs for autoimmune hepatitis or interferon, a medication used to treat a hepatitis infection.

  • Liver transplant may be an option for some people with liver failure. This major surgical procedure involves using a healthy donor liver to replace a severely diseased liver.

What are the possible complications of liver failure?

Liver failure is a life-threatening condition that is often fatal as a result of serious complications and conditions associated with liver failure. In some cases, you may be able to reduce your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications and common coexisting conditions of liver failure include:

  • Ascites, which is a buildup of fluid and swelling in the abdomen

  • Esophageal varices, which is swelling of the veins of the esophagus due to portal hypertension. These bulging veins can burst, leading to life-threatening hemorrhage.

  • Hepatic encephalopathy, which involves changes in the brain due to an inability of the liver to filter toxins, such as ammonia. Hepatic encephalopathy can lead to coma and death.

  • Kidney failure

  • Portal hypertension, which is high blood pressure in a large abdominal vein that can lead to esophageal varices and other problems

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 13
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Cirrhosis. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/.
  2. Cirrhosis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001301/
  3. Liver Disease. Lab Tests Online. http://www.labtestsonline.org/understanding/conditions/liver_disease.html
  4. Liver Disease. University of Maryland Medical Center.  http://www.umm.edu/liver/common.htm
  5. The Progression of Liver Disease. American Liver Foundation.  http://www.liverfoundation.org/abouttheliver/info/progression/
  6. Viral Hepatitis. Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/