Acute Liver Failure - Treatment and Management

Acute liver failure is a sudden and rapid loss of the ability of the liver to perform its functions well. This may happen suddenly and worsen within days or weeks, usually in people who do not have any preexisting liver diseases. Immediate medical attention and treatment of acute liver failure are very important as it can be life-threatening. Also called ‘Fulminant Hepatic Failure’, it is a rare disease and less common than chronic liver failure which occurs over the years. Therefore, through this article, we will give you a fair idea about Acute liver failure, so that you will have an overall knowledge about the disease and know the importance of early detection and its prompt management. Also, we would let you know the place where you can find the best treatment for acute liver failure.

How do you know that someone may have Acute Liver Failure?

If a patient with jaundice develops sleepiness, confusion and disorientation, it indicates onset of Acute liver failure.

How can one get Acute Liver Failure?

The potential causes of Acute Liver Failure are:

• Overuse of certain medications and toxins: Medicines like Acetaminophen (Crocin or paracetamol), some antibiotics, anti-seizure drugs, antidepressants, antifungal drugs, etc.
• Viral Infections: Like Hepatitis A, Hepatitis B, and Hepatitis E, herpes simplex, Cytomegalovirus, etc.
• Metabolic (Biologic) and vascular (Vessels carrying blood and fluids) disorders: like Wilson’s disease and autoimmune hepatitis.

How can Acute Liver Failure be diagnosed?

A detailed medical history assessment, evaluation and then certain tests and diagnostic procedures will be done to confirm if you are suffering from Acute liver failure:

• Blood Tests: like Prothrombin time (to know the clotting time of your blood), bilirubin levels, liver enzymes, etc.
• Imaging Tests: Ultrasound may be done to know the cause of liver damage, CT scan, and MRI to see your liver and blood vessels to rule out any tumors or a disease called ’Budd Chiari Syndrome (Occlusion of veins of the liver).
• Liver Biopsy: A small tissue of your liver may be taken through a needle and sent for examination to find out the reason for liver failure.

What is the treatment of Acute Liver Failure?

The treatment of Acute Liver failure largely depends on its cause. The most important factor in it's reversal is the promptness and correctness of the treatment. Various treatments include:

Medications:

• Activated Charcoal and N-acetyl cysteine:  If your Acute liver failure is due to Acetaminophen overdose, then your doctor will give you activated charcoal which helps to reduce the medicine absorbed in your gastrointestinal tract. Drug N-acetyl cysteine is also prescribed which also reduces the toxicity by acetaminophen and inflammation and improves the flow of blood and oxygen to the tissues.
• Antivirals: If Acute liver failure is caused by viral hepatitis, then medicines will be given depending on the type of hepatitis causing it.
• Steroids: If autoimmune hepatitis is the cause of Acute Liver Failure, then you may be prescribed steroids for the same.
• Antibiotics: Poisoning due to mushrooms etc. can be treated by certain antibiotics.

Supportive Care:

• Fluid management, clotting parameters, bilirubin levels, blood circulation, and oxygen levels are frequently checked and maintained.
• Infection control is very essential to prevent infection in multiple organs which can become a very serious condition.
• Specific therapies for specific conditions will be done as needed like cerebral edema, circulatory failure, kidney failure, Hypoglycemia (Decreased glucose level in the body), and then it will be treated accordingly.
• Nutritional support may be provided through supplements or feeding tubes if you are unable to eat anything by mouth.

Liver Transplant:

When none of the other treatments work, the only option for treatment of Acute Liver Failure is Liver Transplant, which means removing the damaged liver and replacing it with a new healthy liver from a donor. Although it is a major surgery with involved risks but has a high success rate. Your doctor will assess you and the donor thoroughly upon many parameters and then guide you for the same.

There are some new treatments for Acute Liver Failure which are being researched and can prove to be a boon in the coming times:

• Artificial hepatic assist devices: Like a dialysis machine, a machine will act as a liver and do its job, so that a transplant will not be needed.
• Hepatocyte Transplantation: Replacing only the liver cells instead of the entire liver can be done and in some cases, this may lead to complete recovery. Donors having good quality liver are needed for this.
• Auxiliary liver transplantation: This involves removing a small part of your liver and putting a graft in its place, the liver then regenerates and becomes damage-free and healthy.
• Xenotransplantation: The human liver is replaced by an animal or any non-human liver.

All these are under experimentation and will need more research and evaluation but are hoped to be available for treatment options soon.

FAQs

Takeaway

At Samadhan clinic, you will be assured to receive the best treatment for Acute Liver Failure with the highest quality of care and clinical excellence from the best gastroenterologist in Delhi. Dr. Shri Ram Agarwal is a renowned gastroenterologist who has over 20 years of vast experience in his field and has successfully treated hundreds of patients with Acute Liver Disease. His clinical expertise and empathetic attitude towards his patients make him the top gastroenterologist in Delhi. Samadhan clinic is equipped with the latest techniques and modern equipment with high standards of infection control to provide you with the most effective treatment at an affordable cost with the best results.