Acute liver failure (ALF) is a rare but life-threatening condition in which the liver rapidly loses its ability to function. It often occurs in people with no pre-existing liver disease. Because it progresses quickly, it is a medical emergency requiring immediate transfer to a centre with liver transplant capability.
Causes
Common causes in India include:
- Viral hepatitis (hepatitis A, B, E)
- Drug-induced liver injury (paracetamol overdose, herbal medicines, anti-tuberculosis drugs)
- Wilson's disease (a genetic copper metabolism disorder)
- Autoimmune hepatitis
- Unknown cause (in about 15-20% of cases)
Warning Signs
Acute liver failure must be suspected when a person develops:
- Jaundice that worsens rapidly
- Confusion or unusual behaviour (encephalopathy)
- Abdominal swelling
- Bleeding from the gums, nose, or elsewhere
If you see these signs, go to the nearest hospital with liver transplant facilities immediately. Time is critical.
Treatment
Management of ALF is in the ICU:
- Treating the underlying cause
- Supporting failing organ systems
- Managing brain swelling (cerebral oedema)
- Preventing infection and bleeding
In patients who do not improve with medical management, an emergency liver transplant can be life-saving.