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Acute Liver Failure

Medically reviewed by Last updated on Aug 31, 2022.

What is acute liver failure?

Acute liver failure occurs when your liver is damaged and suddenly stops working properly. This may cause damage to other tissues or organs, such as your brain and kidneys. Acute liver failure can become life-threatening.

Abdominal Organs

What causes acute liver failure?

The exact cause of acute liver failure may be unknown, or it may be caused by any of the following:

  • Certain medicines, herbal supplements, and illegal drugs can cause liver damage. An acetaminophen overdose may cause acute liver failure. An overdose can happen by taking too much acetaminophen at one time or over time. Other medicines that can cause liver failure include antiseizure medicines and certain antibiotics. Illegal drugs, such as cocaine, can also cause liver damage.
  • A viral infection may cause hepatitis. Hepatitis causes your liver to swell. Hepatitis can lead to acute liver failure.
  • Autoimmune diseases may cause your body to attack and damage your liver cells.
  • Health conditions , such as Wilson disease or Reye syndrome, may cause acute liver failure. Heart failure, heat stroke, and blood vessel diseases such as Budd-Chiari syndrome, can also cause acute liver failure.
  • Pregnancy-related conditions , such as fatty liver and HELLP syndrome, may cause acute liver failure.
  • Cancer metastasis is cancer that has spread and reached your liver from other parts of your body.

What health problems are caused by acute liver failure?

  • Encephalopathy occurs when harmful substances, such as ammonia, build up and cause brain damage.
  • Bleeding problems may occur because your liver does not produce enough clotting factors. Clotting factors help your blood to clot.
  • Heart and lung problems , such as hypotension (low blood pressure) and pulmonary edema may occur. Pulmonary edema is a buildup of fluid in the alveoli (air sacs) of your lungs. You may also get respiratory distress syndrome. This condition causes damage to the small blood vessels in your lungs.
  • Infections, such as respiratory and urinary tract infections, may occur with acute liver failure.
  • Other health problems , such as kidney failure, hypoglycemia (decreased blood sugar level), and pancreatitis may occur. Pancreatitis is when your pancreas is inflamed (swollen).

What are the signs and symptoms of acute liver failure?

  • Yellowing of your skin or whites of your eyes
  • Pain in the upper right side of your abdomen
  • Itchy skin and a swollen abdomen, feet, and legs
  • Changes in mood, confusion, or increased sleepiness
  • Bleeding and bruising easily
  • Dark bowel movements and decreased or dark urine
  • Loss of appetite, nausea, and vomiting
  • Fatigue and weakness

How is acute liver failure diagnosed?

Your healthcare provider will examine you. He or she will ask if you have had any liver problems in the past. Your provider may ask what medicines you have taken or are presently taking. He or she will also check for other conditions that may be causing your symptoms. You may need any of the following:

  • Blood tests show liver and kidney function. They may also show signs of infection. A blood test may also be done to check how quickly your blood clots. The level of acetaminophen in your blood will be checked if you had an overdose.
  • A neurologic exam can show how well your brain works during your illness. Healthcare providers will check how your pupils (black dots in the center of each eye) react to light. Providers may check your memory and how easily you wake up.
  • An ultrasound or CT may show signs of liver injury. You may be given contrast liquid to help your liver show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • A liver biopsy is a procedure to remove a small piece of your liver. The sample is sent to a lab for tests.

How is acute liver failure treated?

Treatment depends on the cause of your acute liver failure, and other health problems caused by liver failure. The goal of treatment is to decrease damage to your liver and control your symptoms. You will need to stay in the hospital for treatment. If you have a pregnancy-related condition that caused liver failure, you may need to give birth early. You may need any of the following:

  • Medicines may be given to decrease liver damage caused by an acetaminophen overdose. Antivirals help treat or prevent a viral infection. Antiviral medicine may also be given to control symptoms of a viral infection that cannot be cured. Steroids may be given to decrease inflammation. Medicines may be given to treat other health problems caused by acute liver failure. An example is medicine to decrease ammonia levels and treat encephalopathy.
  • A liver transplant may be needed if your liver is badly damaged. All or part of your damaged liver is removed or replaced with a healthy liver from a donor.

Call 911 for any of the following:

  • You have a seizure.
  • You lose consciousness or cannot be woken.
  • You have sudden shortness of breath.

When should I seek immediate care?

  • You feel lightheaded or are too weak to stand.
  • You have shaking, chills, and a high fever.
  • You have trouble thinking clearly, or you are confused.
  • You urinate less than usual, have dark urine, or stop urinating.
  • You vomit blood.
  • You have blood in your bowel movements.
  • You have severe abdominal pain.
  • Your heart is beating faster than usual.

When should I contact my healthcare provider?

  • You bruise or bleed easily.
  • You have new or worse swelling in your legs, ankles, or feet.
  • Your symptoms come back after treatment.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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