Liver failure in adults

Liver failure can develop acutely if a large number of cells die or are damaged at once. Or it develops gradually, when liver tissue is replaced by scars that cannot work properly.

What is liver failure

Liver failure is not a separate disease. This is a syndrome, a set of complaints and symptoms that occur when liver function is impaired.

If the liver, for various reasons, does not fulfill the functions assigned to it, serious metabolic changes develop, severe intoxication with metabolic products occurs, the functioning of the nervous system is disturbed, coma and death may occur.

According to the rate of development of changes, acute liver failure and chronic are distinguished.

Causes of liver failure in adults

Most often, liver failure occurs with infectious lesions of the organ – viral, bacterial, fungal or parasitic. As a rule, these are Botkin’s disease (about 5% of cases), hepatitis B (up to 45% of cases), hepatitis C, delta and E. Risk factors for such a complication are age over 50, alcohol and serious medications, previous liver diseases.

Less commonly, the liver suffers from herpes viruses, Ebstein-Barr, cytomegaly, adenovirus.

In second place in terms of frequency of liver failure are toxins, excessive medication. The liver may suffer from the inappropriate use of paracetamol, diuretics, painkillers or sedatives. A sharp damage to the organ is provoked by mushroom poisons, chemicals (tetrachlorocarbon, phosphorus compounds).

Liver cells can suffer from ischemia if the veins are clogged with a blood clot, there was blood loss, and chronic heart failure develops. Liver tissues are affected by tumors, including metastases and blood cancers.

Rare causes of deficiency are fatty liver (filling cells with fat), an autoimmune process, and rare hereditary diseases. Can lead to acute insufficiency of the operation on the liver and adjacent organs, trauma.

Risk factors for liver failure may include:

• electrolyte imbalance;
• prolonged vomiting and diarrhea with severe dehydration;
• infection;
• alcoholism;
• food protein overload;
• bleeding from the digestive tract.

Symptoms of liver failure in adults

Symptoms of acute or chronic insufficiency depend on the volume of cells affected. It is characterized by a combination of three syndromes:

• hepatocellular insufficiency;
• development of hepatic encephalopathy (brain damage);
• occurrence of hepatic coma.

With the development of insufficiency of liver cells occur:

• jaundice (stained skin, whites of the eyes, mucous membranes of the mouth, tongue);
• spider veins on the skin (capillaries that appear in the skin, similar to spiders);
• swelling of the abdomen, arms and legs;
• hemorrhages under the skin, bruises, bleeding gums;
• indigestion, abdominal pain, diarrhea, frequent vomiting;
• temperature increase;
• weight loss.

If this is a chronic process, hormonal metabolism suffers, there are problems with menstruation in women, sexual function in men, body hair falls out, genitals atrophy. A typical “fruity” or “chemical” odor may come out of the mouth.

With the development of encephalopathy, mental disorders become key:

• emotional swings, bouts of tears, aggression;
• constant anxiety or depression;
• apathy;
• serious sleep disorders;
• disorientation in time or space (the patient does not understand what day, year, does not recognize the area);
• speech or writing disorders;
• constant trembling in the hands;
• excitement;
• coordination disorders, problems with movement;
• change in reflexes.

If liver failure is not eliminated, pre-coma and coma occur. Without assistance and with severe health problems, the death of patients is possible.

Stages of liver failure in adults

According to the severity of the condition and the characteristics of the symptoms in the development of liver failure, there are three main stages:

• compensated (it is also initial), when changes in the liver are quite serious, but the remaining intact cells still cope with their functions;
• pronounced (or decompensated), when there are serious symptoms, the liver cannot cope with the stress;
• terminal (aka dystrophic) with severe changes that lead to the development of coma – in a coma, they can also be isolated to pre-coma, to whom 1 degree and to whom 2 degrees.

Treatment of liver failure in adults

The development of liver failure is a serious complication of problems with the organ. Therefore, it is necessary to identify the disorder as early as possible. With adequate timely treatment, it is possible to significantly improve the functioning of cells and normalize the patient’s condition, slow down the onset of irreversible processes.

Diagnostics

It is impossible to determine liver failure only by the symptoms and complaints of the patient. But it is important to note if a person takes alcohol, has had hepatitis, suffers from metabolic disorders, takes many medications. To confirm the diagnosis, the doctor prescribes a number of tests and tests:

• general blood test – it will have a decrease in red blood cells, increased white blood cells;
• blood clotting determines the decrease in platelets, prothrombin index;
• blood biochemistry will reveal a change in liver enzymes, albumin, bilirubin, electrolytes, creatinine, acid-base state;
• Ultrasound of the liver and abdominal cavity will determine the change in the size of the liver, its density, reveal tumors, problems with blood vessels;
• hepatoscintigraphy can determine hepatitis, cirrhosis, tumors, impaired bile secretion;
• MRI or MSCT will confirm organ damage.

Additionally, an EEG is prescribed to assess the functioning of the brain, a liver biopsy is performed to determine the causes of insufficiency.

Modern treatments

Left untreated, liver failure can quickly lead to death. We asked about the principles of treatment gastroenterologist, hepatologist Ekaterina Myasnikova:

– The choice of a specific method of treatment depends on the severity of the inflammatory process in the liver tissues and, of course, on the cause that led to the development of liver failure:

• viral hepatitis – treatment / maintenance therapy;
• cirrhosis of the liver – liver transplantation;
• alcoholic liver disease – alcohol withdrawal and supportive therapy.

Prevention of liver failure in adults at home

We also clarified whether the prevention of this formidable complication is possible. Dr. Ekaterina Myasnikova suggested following the following principles of prevention:

• get vaccinated against hepatitis A and B;
• do not abuse alcohol, do not take it together with antibiotics, other drugs with high toxicity;
• observe the rules of personal hygiene, do not use other people’s personal hygiene items;
• wash your hands before eating, after the street;
• be careful about transfusion and blood donation;
• contact trusted dentists and cosmetologists, if you are going to do a piercing or tattoo, personally make sure that the instruments are sterile;
• practice protected sex.

Popular questions and answers

How dangerous is liver failure, can it lead to death and is it possible to save the liver – we asked questions gastroenterologist, hepatologist Ekaterina Myasnikova.