• Acute Liver Failure (ALF)

    Acute Liver Failure occurs when the cells of the liver quickly lose the ability to perform routine functions. The liver is a very important organ in the body, and is responsible for filtering waste products, storing nutrients, and moderating chemical levels in the body. When these functions are compromised, complications such as excessive bleeding and increased pressure in the brain may occur. Acute liver failure often occurs over a period of days, whereas most liver conditions are very slow in progression, developing over several years.

    Acute liver failure usually requires hospitalization, and can be treated with successfully, however some patients may require a liver transplant if the condition is severe or irreversible.


    Hepatitis and other viruses: Hepatitis is a virus that may cause inflammation and scarring which may impair the liver’s ability to function. Hepatitis A, B, and C may result in scarring of the liver and potentially liver failure. Autoimmune hepatitis is known to cause the body to attack the liver. Other viruses known to cause complications may be cytomegalovirus, Epstein-Barr, and the herpes simplex virus.

    Cancer: When cancer develops in the liver or moves from another location, the liver’s ability to function may be impaired.

    Acetaminophen overdose: Large doses of acetaminophen (Tylenol®) taken all at once or in excessive doses over the course of several days may impair liver function.

    Prescription Medications: Many prescriptions may impair liver function such as non-steroidal anti-inflammatories (NSAIDS), antibiotics, and anticonvulsants.

    Pregnancy: Late during pregnancy liver function decreases significantly and for some women, liver failure may occur; particularly if the female has a history of any chronic liver disease.

    Unknown: Unfortunately, some cases of liver failure do not have a clear cause.


    Symptoms of acute liver failure often occur quickly and you may notice several of them at once. They are not symptoms to be ignored, especially if they worsen. Seeking treatment may result in a better outcome for your care.

    Warning symptoms:

    • Upper right abdominal pain
    • Nausea
    • Vomiting
    • Confusion or disorientation
    • Jaundice (yellowing of the skin and whites of the eyes)
    • Sleepiness
    • Abdominal distention or swelling

    When to see your doctor:

    If you think you are experiencing a sudden change in your condition with your liver, seek emergency care or call 911. Be sure to see your doctor as soon as possible for any further symptoms.

    Testing and Diagnosis

    To diagnose acute liver failure your physician will take a thorough history and do a physical assessment. Patients should bring a list of any medications they are taking to their appointment including any over-the-counter drugs, herbal supplements or vitamins. Alternately, patients may bring a list of the medications they are taking including dosage strength and schedule.

    During the physical examination, the provider will listen to and feel the abdomen to examine your liver, and will review your vital signs. Patients may be asked difficult questions regarding sexual history, drug and alcohol use; it is important that these questions are answered truthfully so medical care can be tailored to patient needs. In addition, the following tests may be ordered:

    • Blood work
    • Ultrasound, MRI or CT imaging
    • Abdominal x-ray
    • Liver Biopsy


    Due to the numerous causes of liver failure, treatment may vary due to the underlying cause of the liver dysfunction. Most treatments rely on alleviating the complications of liver failure, including draining excess abdominal fluid or fluid on the brain. Patients will be monitored closely and may require monitoring in an intensive care setting to stabilize bodily functions.


    A variety of medications may be used to treat liver failure and will be selected based on the underlying cause of the condition. Additionally, diuretics such as may be used to control fluid accumulation.


    At times, medication and close monitoring are not effective. This may result in the need for a liver transplant.