Acute Liver Failure

The Acute Liver Failure at the Institute for Digestive & Liver Diseases is a specialised, well-equipped unit manned by trained healthcare experts offering effective treatment to patients with Acute Liver Failure (ALF). At least half the patients of ALF can be cured by medical management without a Liver Transplant. Identifying those who will improve with medical management alone is critical in deciding the treatment options for these patients. Those who don’t improve on medical treatment need an early listing for Liver Transplant. We at BLK hospital believe that prevention of infection and appropriate use of renal replacement can save many patients of ALF with or without a transplant. 

Core strengths of BLK'S Acute Liver Failure Unit:

  • Separate Acute Liver Failure ICU 
  • Dedicated medical and paramedical staff well trained in handling ALF patients 
  • Liver Dialysis 
  • Isolation of ALF patients from patients having other liver diseases. In order to prevent cross infection. 
  • State-of-the-art medical care, to manage more than half of all ALF patients without a transplant 
  • Enables timely decision of Liver Transplant 
  • Rapid evaluation of patients requiring transplant (within 24-48 hours)
  • More than 90% success rate of transplant in ALF cases
     

What Is Acute Liver Failure?

Acute liver failure is a rare clinical syndrome that can lead to a life-threatening condition. It is also known as fulminant hepatic failure, which develops when a healthy liver suffers from massive injuries that result in clinical signs and symptoms of liver insufficiency. It involves complications, such as excessive bleeding and increasing pressure in the brain leading to a medical emergency that demand hospitalisation.

What Are The Causes For Acute Liver Failure?

A person suffering from acute liver failure due to end-stage liver disease (ESLD) might experience some of the common causes that lead to such condition of liver failure include:

  • Viral hepatitis (hepatitis A, B, C and E)
  • Iron buildup in the body (hemochromatosis)
  • Inherited disorders of sugar metabolism
    • Galactosemia 
    • Glycogen storage disease
  • Alpha-1 antitrypsin deficiency
  • Accumulation of fat in the liver (nonalcoholic fatty liver disease)
  • Chronic Alcohol abuse
  • Impair blood flow to the liver
  • Consumption of toxic substances such as the poisonous wild mushroom Amanita phalloides
  • Copper accumulated in the liver (Wilson's disease)
  • Diseases in the veins of the liver such as Budd-Chiari syndrome
  • Infection, such as 
    • Syphilis
    • Brucellosis
  • Liver disease caused by your body's immune system (autoimmune hepatitis)
  • Medications such as:
    • Acetaminophen (Tylenol)
    • Antibiotics, 
    • Nonsteroidal anti-inflammatory drugs and
    • Anticonvulsants
    • Methotrexate 
    • Isoniazid

Are You A Candidate Of Acute Liver Failure?

A doctor might evaluate the patient’s current medical condition to know whether he/she is a candidate for Acute Liver Failure. You may suffer from Acute Liver Failure if you experience:

  • Yellowing of your skin and eyeballs (jaundice)
  • Pain in your upper right abdomen
  • Abdominal swelling
  • Cerebral Oedema (Fluid build-up in your brain)
  • Severe breathing problems due to respiratory failure
  • Bleeding (haemorrhage) from the gut (bowel)
  • Disorientation or confusion
  • Excessive Sleepiness
  • Nausea
  • Vomiting
  • A general sense of feeling unwell (malaise)

What Are The Various Diagnosis Tests Required To Diagnose Acute Liver Failure?

Before recommending a Liver Transplant, a doctor might prescribe a patient to undergo a few examinations. The results help the doctor to evaluate the patient’s medical condition and help them create an individualised treatment plan. The list of diagnostic tests for Acute Liver Failure includes: 

  • Complete blood count (CBC)
  • Liver function tests
  • Prothrombin time/INR
  • Imaging tests:
    • Fibroscan
    • Magnetic resonance imaging (MRI) of the abdomen/pelvis 
    • Computed tomography (CT) scan of abdomen/pelvis
    • Ultrasound of abdomen/pelvis
    • Electrocardiogram/chest X-ray
  • Liver biopsy: Invasive examination of liver tissue to understand the reason behind liver failure.
  • Other Blood tests to examine the functioning of the liver

What Is The Treatment Procedure For Acute Liver Failure?

The cause of acute liver failure may need specific treatment. Depending upon the cause, acute liver failure can sometimes be reversed with medication and treatment. However, in most of the serious conditions liver transplant is the only cure.
Acute liver failure treatments include:

  • Medicines:- To reduce the effect of liver failure on your body, your doctor mighty prescribes come medicines which include:cetylcysteine: To reduce acetaminophen overdose
    • Proton pump inhibitor: To reduce stomach acid Other causes of acute liver failure such as Mushroom and other poisonings can also be treated with drugs that can reverse the effects of the toxin. To control the various signs and symptoms your doctor may also prescribe medication for conditions such as:
    • To relieve pressure caused by excess fluid in the brain
    • Screening for infections
    • Preventing severe bleeding
    • Intravenous (IV) fluids to maintain blood pressure
    • Blood glucose (sugar) monitoring
  • Liver transplant: When medication therapy fails to work and unable to reverse acute liver failure, then the only treatment for this disease is a liver transplant. It is a surgical process where a surgeon removes the patient’s damaged liver and replace it with the donor’s healthy liver.When the reversal of acute liver failure is not possible, then the only suitable treatment is a liver transplant. During the process of a liver transplant, a surgeon removes the patient’s damaged liver and replaces it with a healthy liver from a donor (a donor can be a deceased donor or a living related/unrelated donor).

What Are The Precautions One Must Take After The Treatment Of Acute Liver Failure?

The patient must follow the following precautions after the Liver Transplant:

  • Avoiding drinking alcohol 
  • Do not take medications that can harm the liver
  • Eating less fatty foods, including red meat, eggs and cheese
  • Maintain a healthy weight.
  • Control of metabolic risk factors like:
    • High blood pressure
    • Diabetes
    • Cholesterol
  • Cutting down the intake of salt in the diet
  • Get vaccinated
  • Avoid eating wild mushrooms

Are There Any Complications Involved?

 
The surgery might come with mild complications, such as:

  • Electrolyte deficiencies 
  • Bleeding
  • Blood clots
  • Infection at the site of incision
  • Complications with donated liver
    • Rejection 
    • Failure
  • Seizures
  • Recurrence of liver disease 

Anti-rejection medication side effects

After a liver transplant, your doctor might prescribe you to take anti-rejection medications for the rest of your life which can cause side effects such as:

  • Headaches
  • Diarrhoea
  • Diabetes 
  • Bone thinning
  • High blood pressure
  • High cholesterol

These anti-rejection drugs work by suppressing the immune system, thus they come with increased risk for infection. Doctors even prescribe medication to fight the infections caused by these anti-rejection drugs

Find Complete Relief from BLK Experts

If you think you are facing similar conditions, or have suffered from them in the past, please contact the BLK Hospital team to schedule an appointment at : +91-11-30403040

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