Liver failure: symptoms, diagnosis, treatment and prognosis

If the liver no longer functions properly or does not work at all, it is called ‘liver failure’. This is a life-threatening condition that can also seriously hinder the functioning of other organs. Liver failure can occur in either acute or chronic form. The liver performs all kinds of vital functions that are of vital importance.

When does liver failure occur?

The liver breaks down poisons in the blood, among other things. If the liver does not function or functions less, all kinds of toxins can end up in the blood. This can seriously affect the brain and other organs. Liver failure can occur suddenly or as the final stage of a disease. The liver also produces substances that ensure blood clotting and the production of bile. Bile is a fluid that processes fats in the intestines. When the liver no longer works, the toxins accumulate.

Symptoms

The symptoms of acute liver failure can occur within hours to several days. The complaints often start with:

  • Confusion
  • Drowsiness
  • Memory no longer works optimally
  • Muscle twitching/shivers

If liver failure is not treated, other important organs such as the kidneys and lungs also begin to fail. Ultimately, a coma and then death may occur.
In chronic liver failure, the symptoms can persist over a period of months or even years. The main symptoms of chronic liver failure are:

  • Skin and whites of eyes turn yellow
  • Development of bruising and bleeding (spider web-like blood vessels)
  • Belly swells
  • Fingernails take abnormal shape
  • Palms turn red
  • Breast growth in men
  • Shrinking of the testicles in men
  • Blood in stool
  • Fever, vomiting and rapid breathing due to swelling of the brain

 

Transition from chronic liver failure to acute liver failure

When chronic liver failure turns into acute liver failure, the symptoms associated with acute liver failure occur.
The shivering is because the nerves are not working properly again. People with liver failure often have bruising. The abdomen swells due to the accumulation of fluid. Patients with liver failure are at high risk of getting infections and developing kidney failure.

Diagnosis

A doctor can often diagnose liver failure based on the patient’s symptoms. The physical examination looks for, for example, spider web blood vessels, bruises and red dots on the skin, red palms and, in men, enlarged breasts and shrinking testicles. It can also be checked whether the patient is confused or drowsy. Blood tests can be used to determine how the blood clots. If abnormalities are found, this often indicates impaired liver function. In case of fluid accumulation in the abdomen, an ultrasound is performed. A liver biopsy is performed to determine the cause of liver failure. Tissue is then removed from the liver using a hollow needle. Ultrasound can also be used to see what the liver looks like.

Therapy

Treatment of acute liver failure

Acute liver failure requires hospitalization. The patient usually ends up in intensive care. Antibiotics can be administered through an IV to reduce the number of bacteria. These play a role in the accumulation of toxins that cause the deterioration of various organ functions. If medication use is the cause of liver failure, these medications are discontinued. The intestines are often cleaned to get rid of all proteins. In severe liver failure, patients are often artificially ventilated. In patients who survive liver failure, the liver usually heals completely. That can sometimes happen very quickly. It may also be that a liver transplant is the only chance for survival.

Treatment for chronic liver failure

In chronic liver failure, the patient should follow a low-protein diet. This way, fewer toxic substances are produced. Medication that drains fluid ensures that the abdomen does not swell too much. The patient should also not eat too much salt. Drinking alcohol is completely prohibited in case of liver failure. In chronic liver failure, treatment focuses mainly on preventing further deterioration of the liver. Recovery is not possible.

Prognosis in liver failure

In many cases, liver failure requires a liver transplant. This is the case with nine out of ten patients. A liver transplant is not without risks. There is therefore a risk of rejection. In acute liver failure, the liver can sometimes even heal spontaneously. The liver then usually functions completely again. The outlook for chronic liver failure is different, depending on the cause of the liver failure.

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