Doctors can usually diagnose liver failure based on symptoms and results of a physical examination and blood tests. Treatment usually involves controlling protein consumption, limiting sodium in the diet, completely avoiding alcohol, and treating the cause, but sometimes liver transplantation Liver Transplantation Liver transplantation is the surgical removal of a healthy liver or sometimes a part of a liver from a living person and then its transfer into a person whose liver no longer functions.
Characteristic manifestations include Jaundice a yellowish discoloration of the skin and whites of the eyes Cholestasis reduction or stoppage Liver failure can result from many types of liver disorder, including viral hepatitis Overview of Acute Viral Hepatitis Acute viral hepatitis is inflammation of the liver caused by infection with one of the five hepatitis viruses.
In most people, the inflammation begins suddenly and lasts only a few weeks. The scar In general, the amount of alcohol consumed how much, how often, and for how long determines Depending on the amount of acetaminophen in the blood, symptoms range from none at all to vomiting A large portion of the liver must be damaged before liver failure occurs.
Liver failure may develop rapidly over days or weeks acute or gradually over months or years chronic. The liver can no longer adequately process bilirubin a waste product formed when old red blood cells are broken down so that it can be eliminated from the body. Bilirubin then builds up in the blood and is deposited in the skin. The result is jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow.
The liver can no longer synthesize enough of the proteins that help blood clot. The result is a tendency to bruise and bleed Bruising and Bleeding Bruising or bleeding after an injury is normal see also How Blood Clots. However, some people have disorders that cause them to bruise or bleed too easily. Sometimes people bleed without any Blood pressure in the veins that bring blood from the intestine to the liver is often abnormally high called portal hypertension Portal Hypertension Portal hypertension is abnormally high blood pressure in the portal vein the large vein that brings blood from the intestine to the liver and its branches.
Cirrhosis scarring that distorts Fluid may accumulate within the abdomen ascites Ascites Ascites is the accumulation of protein-containing ascitic fluid within the abdomen. Brain function may deteriorate because the liver cannot remove toxic substances as it normally does and these substances build up in the blood. This disorder is called hepatic encephalopathy Hepatic Encephalopathy Hepatic encephalopathy is deterioration of brain function that occurs in people with severe liver disease because toxic substances normally removed by the liver build up in the blood and reach New veins called collateral vessels that bypass the liver may form.
They often form in the esophagus and the stomach. There, the veins enlarge and become twisted. These veins—called varicose veins of the esophagus esophageal varices or stomach gastric varices —are fragile and prone to bleeding Gastrointestinal Bleeding Bleeding may occur anywhere along the digestive gastrointestinal [GI] tract, from the mouth to the anus.
Blood may be easily seen by the naked eye overt , or blood may be present in amounts The kidneys malfunction in up to half of people with liver failure. Kidney failure is the inability of the kidneys to adequately filter metabolic waste products from the blood. People may have metabolic abnormalities, such as a low potassium level in the blood hypokalemia Hypokalemia Low Level of Potassium in the Blood In hypokalemia, the level of potassium in blood is too low.
A low potassium level has many causes but usually results from vomiting, diarrhea, adrenal gland disorders, or use of diuretics. Hypoglycemia is most often caused by drugs taken to control diabetes. Much less common causes of hypoglycemia include other People with liver failure usually have jaundice, ascites, hepatic encephalopathy, and generally failing health.
Jaundice makes the skin and whites of the eyes look yellow. While the word cirrhosis is most commonly heard when people discuss alcohol-induced liver disease , cirrhosis is caused by many forms of liver disease. While fibrosis is reversible there is a point where the damage becomes too great and the liver cannot repair itself. There is no treatment that can cure cirrhosis. If possible, treating the underlying cause of cirrhosis may keep your cirrhosis from getting worse and help prevent liver failure.
Successful treatment may slowly improve some of your liver scarring. It is important to avoid things that could damage your liver further like alcohol, certain medications and fatty food. Treatment for someone with cirrhosis often means managing the symptoms of cirrhosis and preventing further damage to avoid liver failure. Doctors treat liver failure with a liver transplant. Someone with cirrhosis is at a very high risk of developing liver cancer. It is very important to receive routine liver cancer surveillance if you have cirrhosis; most people who develop liver cancer have evidence of cirrhosis.
Doctors also treat liver cancer with a transplant. It is important to note, people often live with cirrhosis for a long time before the option of liver transplant is discussed. There is a big difference between liver functioning and disease progression.
Our livers are resilient, continuing to function even when they become severely scarred. Because of this, some people may not experience symptoms or have elevated liver enzyme tests even though their liver is damaged.
It is important to talk to your doctor about your risks for liver disease so you can receive imaging tests that may help diagnosis liver damage. Compensated Cirrhosis v. Decompensated Cirrhosis Cirrhosis is often categorized as either compensated or decompensated. Their symptoms of the disease may be mild or nonexistent even though the liver is severely scarred. Someone with decompensated cirrhosis will feel and appear sick as their liver is struggling to function.
The liver has two sources that supply blood to the liver — the hepatic artery and the hepatic portal vein. The hepatic artery brings oxygen-rich blood into the liver.
Blood coming from our digestive system enters the liver through the hepatic portal vein carrying nutrients, medications, or toxins. When someone has decompensated cirrhosis the scar tissue blocks the blood meant to flow through the portal vein causing an increase of pressure known as portal hypertension.
The blood unable to enter the liver must find new routes; because the blood is not entering the liver, nutrients, toxins and more from the digestive system does not get properly filtered.
Portal hypertension is responsible for symptoms like varices , ascites and encephalopathy. Hepatorenal syndrome can also occur when someone has decompensated cirrhosis. The increased pressure of portal hypertension causes fluid to seep out and pool in the abdominal cavity. This is called ascites. When large amounts of fluid gather in the belly it can lead to swelling and pain and be very uncomfortable.
Ascites can become infected, which can greatly impact the function of your kidneys, and can even be fatal. Ammonia is a waste product made when our body digests protein. The liver processes the ammonia, breaks it down to something called urea, and sends it to our kidneys to be released in urine. When someone has cirrhosis, ammonia is not eliminated, builds up, travels to the brain, and causes confusion, disorientation, coma, and even death.
This is hepatic encephalopathy. Hepatic Encephalopathy or HE can be managed with medications that are taken regularly. One of these medications tries to eliminate extra ammonia through increasing the number of bowel movements. The other common medication is a powerful antibiotic which eliminates the bacteria in your digestive system responsible for creating the ammonia. Learn more about hepatic encephalopathy in our HE Resource Center. The liver is the largest filter in the body but works closely with our kidneys to eliminate waste from our bodies.
When someone has cirrhosis, they may develop a serious complication where their kidneys begin to progressively fail. This is called hepatorenal syndrome. Our red blood cells have a substance in them called hemoglobin which is responsible for carrying oxygen. Bilirubin is a yellow chemical found in hemoglobin.
Your body builds new cells to replace broken down red blood cells and the old ones are processed in the liver. The breakdown of the old cells releases bilirubin. A healthy liver processes bilirubin out of the body. If the liver cannot successfully do this function, bilirubin builds up in the body and your skin or the whites or your eyes may look yellow. This is called jaundice. Jaundice does not only occur in people with cirrhosis.
Many healthy babies have jaundice during the first week of life. Jaundice can also be due to blood diseases, genetic conditions, blockages of bile ducts, infections like hepatitis A , and even some medications. When blood cannot flow through the portal vein into the liver it is forced to find new pathways, such as through the veins in the stomach and esophagus.
These enlarged veins are called varices. These small veins are not meant to carry so much blood. When overloaded with blood, these veins can balloon, leak blood or even rupture, causing life-threatening bleeding. Signs of bleeding varices include:. Doctors can view these varices by inserting an endoscope a thin flexible tube through your mouth, down to your esophagus and stomach.
Endoscopies are very important to avoid varices from bursting and bleeding. Doctors use endoscopies to check on the varices and, if needed, band them, or tie them off, to strangle the vein and keep them from bursting.
Liver cancer is cancer that begins in the cells of your liver. While several types of cancer can form in the liver, the most common type of liver cancer is hepatocellular carcinoma , or HCC, which begins in the main type of liver cells hepatocytes. Liver cancer is one of the leading causes of cancer-related deaths worldwide. Over the last 30 years, rates of liver cancer have tripled in the United States. While most other common cancers have seen improved survival rates during this time period, liver cancer death rates have doubled.
It is very rare to develop HCC without first having cirrhosis. Because of this, when someone has been diagnosed with advanced fibrosis F3 or cirrhosis they should receive regular surveillance for liver cancer. Finding and diagnosing liver cancer as soon as possible is essential. Early detection offers more potentially curative options, like resection where the cancer and surrounding liver tissue is removed and transplant.
Learn more in our liver cancer resource center. Liver transplantation is a surgical procedure performed to remove a diseased or injured liver from one person and replace it with a whole or a portion of a healthy liver from another person, called the donor.
Since the liver is the only organ in the body able to regenerate, or grow back, a transplanted segment of a liver can grow to normal size within a few months. Often, transplanted livers are from people who were registered donors who passed away.
Since the liver has such regenerative ability, however, it is possible for a living person to donate a portion of his or her liver to someone in need of a transplant. Acute liver failure: When liver failure develops rapidly, typically over days to a few weeks, it is known as acute liver failure. This form of liver failure is rare and often happens in people who have never had previous liver problems.
Causes of acute liver failure include:. Acute liver failure is considered a medical emergency. Patients suffering from acute liver failure are monitored in our state-of-the-art intensive care units. Treatment will depend on the cause of your underlying liver failure.
Medications may help treat hepatitis, acetaminophen overdoses, poisonings and other causes. If treatment is not effective, you or your loved one will be evaluated for a possible liver transplant. Acute-on-chronic liver failure: Sometimes people with chronic liver failure who are clinically stable suddenly develop rapid progression of the liver failure. There are various causes for the rapid worsening of the liver function, including an infection, drinking some alcohol despite having a cirrhotic liver or ingesting medications that may unexpectedly harm the liver.
Patients with acute-on-chronic liver failure may see their livers fail over weeks to months, compared to months to years as is typical in chronic liver failure. As with acute liver failure, we focus first on treating the underlying cause of sudden liver failure before considering a possible liver transplant. In many cases, the only treatment for liver failure is a liver transplant. However, liver failure is sometimes brought on by an acute or hereditary cause that can be treated.
For instance, when liver failure is caused by ingesting too much acetaminophen an over-the-counter pain reliever , we will use medicine to counteract the effects of this common drug to reduce liver damage.
When liver failure results from a hereditary copper-overload disease, we will use medications to remove the copper out of the body. Or when liver failure is precipitated by an infection in patients with cirrhosis, we will use antibacterial medicines to fight the infection to, hopefully, return the liver to its previous functional state.
The Molecular Adsorbent Recirculating System MARS is a liver dialysis machine used in the treatment of liver failure to enable native liver regeneration. It removes protein-bound and water-soluble toxins from the blood and reduces the amounts of toxins that reach the brain. The MARS system helps prevent irreversible organ failure and improves liver regeneration and recovery. UChicago Medicine is the only center in the Chicagoland area to offer this complex medical therapy.
Early on, liver damage may not cause any symptoms. A failing liver is usually detected with blood tests. Over time, you may notice jaundice and other symptoms highlighted above. Liver failure is when the liver has shut down or is shutting down. Cirrhosis is a late stage of liver disease where the liver is severely scarred but may still be able to perform its function to support life.
When the liver is no longer able to perform its work adequately, its goes into liver failure. Most patients who develop chronic liver failure have underlying cirrhosis. Liver disease can go through these stages:. A liver with no cirrhosis has a high capacity to regenerate itself. If patients follow treatment recommendations, their livers can regain normal function.
Treatment often involves adopting healthy behaviors, such as reducing alcohol intake for people with alcoholic liver disease or weight reduction for those with nonalcoholic fatty liver disease that is precipitated by excess weight.
We look at four lab results:. The worse your liver function, the higher your MELD score will be, and the higher your risk of death.
The MELD score can be calculated using a programmed equation. With access to leading therapies and state-of-the-art technologies, our liver disease specialists work together to provide personalized care for each patient. Our internationally renowned specialists have extensive expertise in treating common and complex liver diseases. Some people with liver disease have related medical problems in other areas, such as diabetes, kidney disease or heart disease.
At UChicago Medicine, all of our highly specialized physicians work under the same roof and are in continual communication with one another. Whether you need care from an endocrinologist, nephrologist, cardiologist, transplant surgeon or any other specialist, you can be assured that these specialists will collaborate on your behalf. Individually tailored treatment, personalized support and ongoing education help patients through the lengthy and often challenging journey of living with liver disease.
Nurse specialists, physician assistants, social workers, registered dietitians and other members of our team have important roles supporting each patient and their family throughout treatment. Our team oversees many clinical trials of new therapies for liver disease.
Research leads to better ways to treat, diagnose and even prevent liver disease.
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