What is Acute Liver Failure?

Dr Priya Sharma

Dr Priya Sharma

BDS (Bachelor of Dental Surgery), 6 years of experience

December 28, 2021 Liver Section 384 Views

English हिन्दी Bengali

What is the meaning of Acute Liver Failure?

Acute liver failure is a rapid loss of liver function in a few days or weeks. It usually occurs in a person who has no preexisting liver disease. It is most commonly caused by the hepatitis virus or drugs such as acetaminophen. Acute liver failure is less prevalent than chronic liver failure, which develops more slowly.

Acute liver failure is also known as a fulminant hepatic failure and it can cause serious complications, including excessive bleeding and increased pressure in the brain. It is a medical emergency in which the patient requires immediate hospitalization. 

Depending on the cause of the condition, acute liver failure can sometimes be reversed with appropriate treatment. But in many situations, a liver transplant may be the only form of treatment.

Let us tell you about Acute Liver Failure in today’s article.

  • What is Acute Liver Failure?
  • What are the symptoms of Acute Liver Failure?
  • How to diagnose Acute Liver Failure?
  • What is the treatment of Acute Liver Failure?
  • What is the care after a liver transplant surgery?
  • What are the complications of Acute Liver Failure?
  • How to prevent Acute Liver Failure?

What is Acute Liver Failure?

Acute liver failure (ALF) is a condition that often occurs when too many cells in the liver die in a short period of time (usually a few days to weeks), destroying most of the liver’s ability to function.

Acute liver failure usually develops rapidly and requires immediate patient care and it should not be confused with other types of liver failure due to cirrhosis (late-stage liver disease) or chronic hepatitis (long-term inflammation of the liver), which usually takes years to progress.

What are the causes of Acute Liver Failure?

The causes of acute liver failure could be:

  • Overdose of Acetaminophen: A high dose of paracetamol or acetaminophen (a type of medication used for pain) can cause acute liver failure.

( Know more aboutUses and Benefits of Paracetamol )

  • Other medications: The use of certain medications like antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs can cause acute liver failure.
  • Herbal supplements: The use of certain herbal supplements have been linked to acute liver failure.
  • Hepatitis: The inflammation of the liver is known as hepatitis. Hepatitis A, hepatitis B, and hepatitis E can lead to acute liver failure.

( Know more about- What is Hepatitis B? Causes, Symptoms, Treatment, Prevention )

  • Other viruses: Certain viruses like the Epstein-Barr virus (a type of virus that is spread by the saliva), herpes simplex virus (a virus that spreads by skin-to-skin contact), and cytomegalovirus (a common type of virus that may cause chickenpox and cold sores) can cause acute liver failure.
  • Toxins: Toxins like the industrial chemical that is found in refrigerants, varnishes, solvents for waxes; carbon tetrachloride; and a type of poisonous wild mushroom known as amanita phalloides can cause acute liver failure.
  • Autoimmune disease: Autoimmune hepatitis, a condition in which the body’s immune system attacks the liver cells causing injury and inflammation to the liver, is known as an autoimmune disease.
  • Cancer: Cancer that may begin in the liver or spreads to the liver can cause acute liver failure.

( Know more about- What is Liver Cancer? Causes, Symptoms, Treatment, Prevention )

  • Vein diseases: Certain disorders like the Budd-Chiari syndrome can lead to blockages in the veins of the liver, causing acute liver failure.

( Know more about- What is Deep vein thrombosis? )

  • Heatstroke: Strenuous physical activity in extreme heat can lead to acute liver failure.
  • Sepsis and shock: Sepsis (a severe type of infection) and shock can disrupt the blood flow to the liver causing acute liver failure.
  • Metabolic diseases: A few metabolic diseases like acute fatty liver of pregnancy (a condition in which there is too much fat deposit in the liver cells during pregnancy) and Wilson’s disease (an inherited disease in which there is copper accumulation in the organs) are rare causes of acute liver failure.

( Know more about- What is Wilson’s Disease? )

A few cases of acute liver failure have no known cause.

What are the symptoms of Acute Liver Failure?

Signs and symptoms of acute liver failure are as follows:

  • Yellowing of a person’s skin and eyeballs (jaundice)

( Know more about- Diet for Jaundice Patients )

  • Pain in your upper right abdomen
  • Abdominal swelling (ascites)
  • Nausea
  • Vomiting
  • Feeling unwell
  • Disorientation or confusion
  • Lethargy
  • The breath may have a musty or sweet smell
  • Tremors

Acute liver failure is life-threatening and develops rapidly in an otherwise healthy person. If you notice any sudden yellowing of the eyes or skin, tenderness in the upper abdomen, any unusual changes in mental status, personality, or behavior, contact a doctor immediately.

( Know more about- What is Liver Cirrhosis? Causes, Symptoms, Treatments, Prevention )

How to diagnose Acute Liver Failure?

The following tests are used to diagnose the acute liver failure.

Blood tests:

  • Doctors prescribe blood tests to find out how well your liver is working.
  • The prothrombin time test indicates how long it takes for your blood to clot. With acute liver failure, the blood does not clot as quickly as it should.

Imaging tests:

  • Ultrasound: The doctor may recommend an ultrasound exam in which sound waves are used to view your liver. This type of test can show liver damage and help your doctor find the cause of your liver problems.
  • Computed Tomography (CT) scan: This imaging test makes use of a series of x-rays and a computer to obtain clear images of the liver and blood vessels.
  • Magnetic resonance imaging (MRI) scan: This test makes use of magnetic waves to obtain clear images of the liver.

( Know more about- What is Endoscopy? )


  • Your doctor may remove a small piece of your liver tissue (liver biopsy). This can help your doctor understand why your liver is getting damaged.
  • However, people with acute liver failure are at high risk of bleeding during the biopsy.
  • The doctor may alternatively perform a transjugular liver biopsy in which the doctor makes a small incision on the right side of the neck and then passes a thin tube (catheter) into a neck vein, through the heart, and into the vein exiting the liver. Then the doctor inserts a needle through the catheter and removes a sample of liver tissue.

( Know more about- What Are Liver Function Tests? Purpose, Procedure, Results, Cost)

What is the treatment of Acute Liver Failure?

Acute liver failure progresses very fast, so timely treatment is necessary. Such patients must be treated by a doctor experienced in acute liver failure and liver transplantation.

Liver damage itself may not have any form of treatment. But, treatment may involve controlling the complications and allowing time for the liver to heal.

Treatment for acute liver failure includes:


  • A medicine known as acetylcysteine may treat an acute liver failure that is caused due to paracetamol overdose.
  • Mushroom poisoning and other types of poisoning can be treated using medicines that can reverse the toxin effects and reduce damage to the liver.
  • Relief of the increased pressure caused due to the excess fluid in the brain (called cerebral edema) may be obtained with the help of some medications.
  • Blood and urine samples of the acute liver failure patient are taken regularly to test for infections. If infections are diagnosed, medications are prescribed by the doctor to treat the same.
  • In case of severe loss of blood, the doctor may prescribe certain medications. The doctor may also advise blood transfusions.
  • Medical supplements may be prescribed for the treatment of nutrition deficiency.

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Liver transplant:

  • When acute liver failure cannot be reversed, the only form of treatment that can be effective is a liver transplant. In this procedure, the surgeon will remove the damaged liver and replace it with a healthy donor liver.

The indicators of liver transplant include:

  • High levels of jaundice (greater than 12 mg/dL)
  • Worsening of clotting indicated by prothrombin time (PT) greater than 50 seconds
  • Worsening of mental status or coma
  • When the interval between onset of jaundice and mental confusion/sleep is more than 7 days
  • W the patient is less than 10 or over 40 years of age
  • Renal function worsens.

Patients who have three or more of these indicators have less than a 10% chance of survival without a transplant and about 60% with one.

  • The procedure is performed under general anesthesia (the patient is made to fall asleep during the procedure).
  • Liver transplant can be done from a deceased donor (the whole liver is replaced) or a living donor, who (donation of a part of the healthy liver)
  • The procedure of liver transplant includes:
  • A long incision is made by the surgeon across the abdomen (stomach) to access the liver.
  • The donor’s liver is then removed and placed in the body.
  • The blood vessels and bile (liver) ducts are connected to the donor’s liver.
  • The surgeon then closes the incision using stitches (sutures).
  • The surgery may take about 12 hours to complete.

( Know more about- What is Liver Transplant Surgery? Purpose, Tests, Procedure, Cost )

There are many renowned hospitals and doctors in India where Liver Transplant Surgery is done with great expertise.

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What is the care after a liver transplant surgery?

  • The patient is expected to stay in the hospital for 5 to 10 days after a liver transplant surgery.
  • The doctor will prescribe some medications that need to be taken life-long after the procedure.
  • The patient can resume work only after a couple of months of surgery. Complete recovery may take up to 6 months.
  • Regular checkups by the doctor are mandatory after the procedure.
  • Eat a well-balanced diet.
  • Exercise regularly.
  • Quit consumption of alcohol.

( Know more about- What is Fatty Liver? Causes, Symptoms, Treatments, Prevention )

What are the complications of Acute Liver Failure?

The complications of acute liver failure may include:

  • Cerebral edema: Acute liver failure may cause fluid buildup in the brain. This is known as cerebral edema and may cause high blood pressure.

(Know more about- What are CSF leaks and treatments? )

  • Infections: Acute liver failure may cause infections like urinary tract infections and pneumonia (infection of one or both the lungs).

( Know more about- What are Staph Infections? )

  • Problems in the clotting of blood: Blood clots are gel-like collections of blood that are formed during an injury to prevent bleeding.
  • Kidney failure: Acute liver failure can lead to failure of the kidneys.

(Know more about-What is Kidney Transplant Surgery?Purpose,Tests,Procedure,Aftercare,Cost)

How to prevent Acute Liver Failure?

Acute liver failure can be prevented by the following methods:

  • Acetaminophen or paracetamol should be strictly taken as per the recommended dosage given by the doctor. An overdose should be avoided to prevent acute renal failure.
  • It is important to tell the doctor about any medications you may be taking as some herbal supplements or over-the-counter medications that you may be taking can interfere with the prescription drugs that the doctor may give leading to acute renal failure.
  • Alcohol consumption should be in moderation.
  • Get vaccine shots for hepatitis A and hepatitis B virus.
  • Quit smoking.
  • Avoid sharing razor blades and toothbrushes to prevent the spread of hepatitis virus, which may cause acute liver failure.
  • Use condoms during sex.

( Know more about- What is a Condom? Usage, Benefits, Side effects )

  • If you are getting a body piercing or tattoo done, do it in a clean and sanitized place with aseptic (free from disease-causing germs) instruments.
  • Avoid eating wild mushrooms.
  • Keep the room well-ventilated or wear a mask when using an aerosol spray.
  • Maintain a healthy weight.
  • Cover your skin by wearing gloves, full-sleeved clothes, a mask, and a hat.

We hope that we could answer all your questions regarding Acute Liver Failure through this article.

If you want more information and treatment about Acute Liver Failure, you can contact a Hepatologist.

We only aim to provide you with information through this article. We do not recommend any medicine or treatment to anyone. Only a doctor can give you good advice and the correct treatment plan.

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