Acute Liver Failure Treatment In India - Dr. Shailendra Lalwani

Acute liver failure is the condition occurs when a person suffers from acute liver dysfunction – a rapid reduction in the physiological capacity of lungs- within days or weeks. There is no underlying chronic disease of the liver in a patient yet the liver function tests are abnormal in acute liver failure. The patient may have an altered level of consciousness due to hepatic encephalopathy. The condition is less common as compared to chronic liver disease which progresses slowly. Medical intervention is immediately required in acute liver failure.

What Are The Symptoms Of Acute Liver Failure?
Acute liver failure is a life-threatening condition and requires hospitalization. The symptoms appear suddenly in an otherwise healthy person. Following are some of the symptoms experienced by the patient with acute liver failure:

Excessive bleeding due to reduced capacity of coagulation
Yellowing of skin and eyes – a condition known as jaundice- due to liver dysfunction.
Malaise and anorexia as a causative disorder
Ascites
Purpura
Motor dysfunction
A sweet breath odor- fetor hepaticus- is a common symptom.
Hypotension, tachycardia, or tachypnoea
Abdominal swelling
Nausea and vomiting
Sleepiness
Pain in the upper right region of the abdomen
What Are The Causes Of Acute Liver Failure?
Rapid reduction in the capacity of liver cells occurs in acute liver failure. Following are some of the causes of acute liver failure:

Autoimmune disease: Acute immune reactions against the liver cells may result in acute autoimmune hepatitis.

Paracetamol toxicity: Prolonged intake of higher than the recommended dose of paracetamol is one of the common reasons for acute liver failure.

Cancer: Cancer, either primary or secondary liver cancer, may lead to acute liver failure.

Metabolic diseases: Acute fatty liver in pregnancy may lead to acute liver failure. Wilson’s disease, a rare disease, may also cause acute liver failure.

Exposure to toxins: Exposure to toxins such as carbon tetrachloride may result in acute liver failure.

Vascular diseases: Blockage of blood vessels supplying nutrition and oxygen to liver cells can cause acute liver failure.

Medications and supplements: Various medications and herbal supplements are linked to acute liver failure.

What Is The Pathophysiology Of Acute Liver Failure?
Acute liver failure not only affects the liver, but various organ systems are critically affected. Affected organs systems include:

Nervous system: Hepatic encephalopathy is the condition caused due to acute liver failure. It is due to the increased level of ammonia. In severe cases, the patient may have cerebral edema.
Renal:Most patients with acute liver failure also have kidney failure. The exact link for such occurrence is not known.
Cardiovascular: There are an increased heart rate and cardiac output in patients with acute liver failure.
Pulmonary: Patients with acute liver failure may suffer from pulmonary edema.
Metabolic: Acute liver failure may cause hypoglycemia, hypokalaemia, hypophosphatemia, and metabolic acidosis.
How The Diagnosis Of Acute Liver Failure Is Done?
Following are the diagnostic techniques for acute liver failure:

Imaging techniques: Imaging techniques such as CT scan and Ultrasound are used to determine the extent of liver damage and cause of liver disease.

Blood tests: Blood tests such as liver function tests are conducted to analyze the functional capacity of the liver.

Liver biopsy: Liver biopsy is done to identify the cause of liver failure.

What Are The Treatment Options For Acute Liver Failure?
Treatment options for acute liver failure are:

Medications for treating toxicity: Toxic effects of paracetamol and mushrooms should be controlled through medications.

Liver transplantation: In some cases, the hepatologist may recommend liver transplantation.

Apart from the above, the supportive measures depending upon the symptoms is also provided to the patient.

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