Acute Liver Failure

What Is Acute Liver Failure (ALF)?

Acute liver failure (ALF) is a sudden loss of liver functioning, also known as fulminant hepatic failure (FHF). It occurred rapidly, may be related to some specific reason like viral infection or drug related. It may be simply worsening of acute hepatitis, which becomes a serious problem and can be life threatening, due to internal bleeding or due to severe brain edema leading to increased pressure in the brain. In such condition, an urgent transplant may be the only curative, life saving option.

Acute Liver Failure (ALF) occurs when a there is a severe insult to the liver in a short span of time (usually within few days to weeks), leading to rapid decline in the liver function. These individuals rapidly develop jaundice (yellowing of eyes/ dark yellow urine), coagulopathy (bleeding tendency) along with altered level of consciousness and may go into coma.

Chronic Liver Disease

It need to be carefully diagnosed and should not be confused with other diseases/ intoxication or other liver diseases like Cirrhosis or Chronic Hepatitis.

Symptoms of Acute Liver Failure includes jaundice, altered sensorium, dark colored urine, bleeding tendency. The criteria ro decide need to transplant includes King’s college Criteria and Model for End-Stage Liver Disease (MELD) score.

The common causes of acute liver failure are Hepatitis A, Hepatitis E, pregnancy, Hepatitis B, toxic doses of paracetamol (Crocin, Tylenol) and other drugs, and Wilson’s disease (defect of copper metabolism). In one third of the cases, the cause remains unknown.

Treatment of Acute Liver Failure in India

ALF is a life-threatening emergency. The patient with a diagnosis of ALF should be managed at medical centers with advanced healthcare facilities and appropriate expertise. Such patients need to be admitted to ICU under the care of doctors experienced in treating ALF and in liver transplantation.

Most of these patients can be successfully treated, even without liver transplant in a dedicated Liver ICU Unit with supportive care and medicines.