Liver Failure Solicitors - Medical Negligence Compensation Lawyers
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Liver Failure Overview
Acute liver failure or ALF is an unusual condition in which there is rapid deterioration of the function of the liver such that there are bleeding problems, problems in mental status and sometimes death. It means there is a hepatic encephalopathy that occurs without preexisting cirrhosis of the liver and with an illness that lasts less than 26 weeks. Fulminant liver failure occurs within 8 weeks of the onset of symptoms while sub fulminant hepatic failure occurs within 26 weeks of the onset of symptoms.
The leading cause of hepatotoxicity that leads to liver failure is drugs and medications. If these people get hepatic failure, they need a liver transplant in order to supply the body with all of the things that the liver is supposed to do. Mortality rate is around 80 percent. About six percent of liver transplants that occur in the US are due to acute liver failure. The survival rate after getting the transplant is around 60 percent. There are now some liver support systems that can support the liver like dialysis but they do not affect the survival rate.
Acute liver failure results in an increase in ammonia in the body which, in turn, causes hepatic encephalopathy or coma and confusion related to too much ammonia in the system. There is an increase in blood flow and blood volume in the brain so that there is cerebral oedema, the cause of hepatic encephalopathy.
The incidence of acute hepatic failure is low; about 2000 cases occur each year in the US. More than half of all cases are due to drugs such as acetaminophen or other drug reaction. About fifteen percent have no known cause. Other, less frequent, causes include hepatitis B, autoimmune hepatitis, Wilson disease or fatty liver of pregnancy. A pregnancy condition called HELLP syndrome causes liver failure along with other medical problems.
In other countries, hepatitis B, Hepatitis Delta and Hepatitis E are more common causes of acute liver failure. Hepatitis E is a common cause of acute liver failure in pregnant women in Mexico, Central America, India and the Middle East.
The rate of death depends on the stage of the hepatitis. Survival rate if the liver failure is due to hepatitis A is more than 60 percent. The survival rate is greater than that if the individual has acetaminophen toxicity. Wilson disease causes almost consistently fatal acute liver failure unless a liver transplant is given. People under the age of 10 years and over the age of 40 do worse than others with the disease. If the encephalopathy lasts longer than two weeks, the prognosis is poor.
Autoimmune hepatitis and viral hepatitis E are more common to women than men. Overall 73 percent of women who have acute fulminant liver failure are women. Most people have the disease in their 30s.
The diagnosis of acute liver failure depends on the history and physical exam. The history can reveal acetaminophen use or history of hepatitis. The physical exam will show jaundice and a diminished mental status. The liver may be enlarged or very small due to liver necrosis. A CT scan of the abdomen can show what the liver looks like as can an MRI exam or ultrasound of the liver. These tests can also show cerebral oedema, consistent with hepatic encephalopathy. Ascites or a collection of fluid in the abdomen can occur when the liver fails to process blood flowing through it. There can be blood in the vomitus or in the stool from the effect of the damaged liver on the gastrointestinal tract. The patient also has a low blood pressure and a rapid heartbeat because of a lack of systemic blood flow.
The treatment of acute liver failure involves supporting the liver as much as possible until a liver transplant is available. Liver transplants are dangerous but are less dangerous than dying from acute liver failure.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here