KidsMD Health Topics

Acute Liver Failure

  • What is liver failure?

    Liver failure is severe deterioration of liver function. Liver failure occurs when a large portion of the liver is damaged due to any type of liver disorder.

    What causes liver failure?

    A number of liver diseases, such as biliary atresia, metabolic liver disease and hepatitis, can lead to liver failure as they progress into late stages. Liver diseases that lead can lead to liver failure share the following characteristics:

    • Jaundice: is a yellow discoloration of the skin and whites of the eyes due to an abnormally high level of bilirubin (bile pigment) in the bloodstream, which is then excreted through the kidneys. High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells, or blockage of the bile ducts. Sometimes jaundice is caused by the breakdown of a large number of red blood cells, which can occur in newborns. Jaundice is usually the first sign, and sometimes the only sign, of liver disease.

    • Cholestasis is reduced or stopped bile flow. "Chole" refers to bile and "stasis" means "keeping at the same level." Bile flow may be blocked inside the liver, outside the liver, or in both places. Cholestasis is caused by hepatitis, metabolic liver diseases, drug effects, a stone in the bile duct, bile duct narrowing, biliary atresia, or inflammation of the pancreas. Symptoms of cholestasis may include the following: jaundice, dark urine, pale stool, easy bleeding, itching, small, spider-like blood vessels visible in the skin, an enlarged spleen, fluid in the abdominal cavity, chills and abdominal pain.

    • Liver enlargement (hepatomegaly) is usually an indicator of liver disease. There are usually no symptoms associated with a slightly enlarged liver. Symptoms of a grossly enlarged liver include abdominal discomfort or "feeling full."

    • Portal hypertension is abnormally high blood pressure in the portal vein, which brings blood from the intestine to the liver. Portal hypertension may be due to increased blood pressure in the portal blood vessels or resistance to blood flow through the liver. Portal hypertension can lead to the growth of new blood vessels (called collaterals) that connect blood flow from the intestine to the general circulation, bypassing the liver. When this occurs, substances that are normally removed by the liver pass into the general circulation. Symptoms of portal hypertension may include: a distended abdominal cavity (ascites), prominence of abdominal wall veins, bleeding of the varicose veins at the lower end of the esophagus or the stomach lining.

    • Ascites - Ascites is fluid build-up in the abdominal cavity caused by fluid leaks from the vessels on the surface of the liver and intestine. Ascites due to liver disease usually accompanies other liver disease characteristics such as portal hypertension. Symptoms of ascites may include a distended abdomen, which causes discomfort and shortness of breath.

    • Liver encephalopathy - Liver encephalopathy is the deterioration of brain function due to toxic substances building up in the blood which are normally removed by the liver. Liver encephalopathy is also called portal-systemic encephalopathy, hepatic encephalopathy, or hepatic coma. Symptoms of liver encephalopathy may include: changes in logical thinking, personality, and behavior, mood changes impaired judgment, drowsiness, confusion, sluggish speech and movement, disorientation, loss of consciousness, coma

    What are the symptoms of liver failure?

    • jaundice
    • tendency to bruise or bleed easily
    • ascites
    • impaired brain function (encephalopathy)
    • poor weight gain and growth
    • fatigue
    • weakness
    • nausea
    • loss of appetite

    How is liver failure and diseases that lead to liver failure diagnosed?

    When diagnosing liver disease, the physician looks at the patient's symptoms and conducts a physical examination. In addition, the physician may request a combination of the following tests:

    Blood Tests:

    • Liver enzymes - Elevated levels of liver enzymes can alert physicians to liver damage or injury, since the enzymes leak from the liver into the bloodstream under these circumstances.

    • Bilirubin - Bilirubin is produced by the liver and is excreted in the bile. Elevated levels of bilirubin often indicate an obstruction of bile flow or a defect in the processing of bile by the liver.

    • Albumin, Total Protein, and Globulin - Below-normal levels of proteins made by the liver are associated with many chronic liver disorders.

    • Clotting Studies, such as Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) - Tests that measure the time it takes for blood to clot are often used prior to liver transplantation. Blood clotting requires vitamin K and proteins made by the liver. Liver cell damage and bile obstruction can both interfere with proper blood clotting.

    Other diagnostic tests can include:

    • Abdominal Ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

    • Liver Biopsy - a sample of liver tissue is obtained with a special biopsy needle and examined under a microscope.

    • Computed Tomography Scan (Also called CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

    How is liver failure treated?

    In most cases, late stage liver disease, resulting in liver failure requires a liver transplantation. A liver transplant is an operation performed to replace a diseased liver with a healthy one from another person. For more information on liver transplants, see Liver Transplantation.

  • What causes liver failure?

    A number of liver diseases, such as biliary atresia, metabolic liver disease and hepatitis, can lead to liver failure as they progress into late stages.

    Liver diseases that can lead to liver failure share the following characteristics:

    • Jaundice - A yellow discoloration of the skin and whites of your child’s eyes due to an abnormally high level of bilirubin (bile pigment) in his bloodstream.
      • High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells or blockage of the bile ducts.

      • Sometimes jaundice is caused by the breakdown of a large number of red blood cells, which can occur in newborns.

      • Jaundice is usually the first sign, and sometimes the only sign, of liver disease.

    • Cholestasis - Reduced or stopped bile flow.

      • Bile flow may be blocked inside your child’s liver, outside the liver or in both places.

      • Cholestasis can be caused by hepatitis, metabolic liver diseases, drug effects, a stone in the bile duct, bile duct narrowing, biliary atresia or inflammation of the pancreas.

      • Symptoms of cholestasis may include the following:

        • dark urine
        • jaundice
        • pale stool
        • easy bleeding
        • itching
        • small, spider-like vessels visible in the skin
        • enlarged spleen
        • fluid in the abdominal cavity
        • chills
        • abdominal pain
    • Liver enlargement (hepatomegaly) is usually an indicator of liver disease.
      • There are usually no symptoms associated with a slightly enlarged liver.
      • Symptoms of a grossly enlarged liver include abdominal discomfort or "feeling full."
    • Portal hypertension — Abnormally high blood pressure in your child’s portal vein, which brings blood from the intestine to the liver.
      • Portal hypertension may be due to increased blood pressure in the portal blood vessels or resistance to blood flow through the liver.

      • Portal hypertension can lead to the growth of new blood vessels that bypass the liver.

      • When this occurs, substances that are normally removed by the liver pass into the general circulation.

      • Symptoms of portal hypertension may include:

        • a distended abdominal cavity (ascites)

        • prominence of abdominal wall veins

        • bleeding of the varicose veins at the lower end of the esophagus or the stomach lining

    • Ascites — Fluid build-up in your child’s abdominal cavity caused by fluid leaks from the vessels on the surface of the liver and intestine.
      • Ascites due to liver disease usually accompanies other liver disease characteristics such as portal hypertension.

      • Symptoms of ascites may include a distended abdomen, which causes discomfort and shortness of breath.

    • Liver encephalopathy — The deterioration of your child’s brain function due to toxic substances building up in the blood which are normally removed by the liver.

      • Liver encephalopathy is also called portal-systemic encephalopathy, hepatic encephalopathy, or hepatic coma.

      • Symptoms of liver encephalopathy may include:

        • changes in logical thinking, personality and behavior
        • mood changes
        • impaired judgment
        • drowsiness
        • confusion
        • sluggish speech and movement
        • disorientation
        • loss of consciousness and coma

    What are the symptoms of liver failure?

    • jaundice
    • tendency to bruise or bleed easily
    • ascites
    • impaired brain function (encephalopathy)
    • poor weight gain and growth
    • fatigue
    • weakness
    • nausea
    • loss of appetite
  • How is liver failure diagnosed?

    When diagnosing liver disease, your child’s physician looks at your child’s symptoms and conducts a physical examination. In addition, the physician may request a combination of the following tests:

    Blood tests

    • Albumin level: A sample of blood is obtained from your child's vein. Below-normal levels of albumin — a protein made by the liver and found in the bloodstream — are associated with many chronic liver disorders.
    • Bilirubin level: A sample of blood is taken from your child's vein. Bilirubin is produced by the liver and is excreted in the bile. Elevated levels of bilirubin may indicate an obstruction of bile flow or a defect in the processing of bile by the liver.
    • Liver enzymes: A sample of blood is taken from your child's vein, and the amounts of enzymes that the liver normally makes are measured. Elevated levels of liver enzymes can alert physicians to liver damage or injury, since the enzymes leak from the liver into the bloodstream under these circumstances.
    • Prothrombin time (PT) test: This test measures the time it takes for blood to clot. Blood clotting requires vitamin K and a protein made by the liver. Liver cell damage and bile flow obstruction can both interfere with proper blood clotting.

    Abdominal ultrasound (also called sonography)

    Ultrasounds are used to view your child’s liver as it functions to and assess blood flow through various vessels

    Liver biopsy

    A procedure that takes a small tissue sample for examination.

    Computerized tomography scan (CT or CAT scan)

    A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called “slices”), both horizontally and vertically, of your child’s liver.

    • A CT scan shows a detailed image of your child’s liver. CT scans are more detailed than general x-rays.

    • Your child will lie on a bed that moves into a doughnut shaped machine that takes many pictures of different areas of the body.

    • Because the machine is noisy, and because your child may need to lie still for a while with his arms over his head, a sedative might be given to help your child rest during the procedure.

  • How is liver failure treated?

    It depends on whether the liver disease is diagnosed and treated before your child's liver fails.

    • Treatment at an early stage of liver disease can be quite successful.
    • Late-stage liver disease, resulting in liver failure, requires a liver transplantation.
    • A liver transplant is an operation performed to replace a diseased liver with a healthy one from another person.
Request an Appointment

If this is a medical emergency, please dial 9-1-1. This form should not be used in an emergency.

Patient Information
Date of Birth:
Contact Information
Appointment Details
Send RequestIf you do not see the specialty you are looking for, please call us at: 617-355-6000.International visitors should call International Health Services at +1-617-355-5209.
Please complete all required fields

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

Thank you.

Your request has been successfully submitted

You will be contacted within 1 business day.

If you have questions or would like more information, please call:

617-355-6000 +1-617-355-6000
close
Find a Doctor
Search by Clinician's Last Name or Specialty:
Select by Location:
Search by First Letter of Clinician's Last Name: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
BrowseSearch
Condition & Treatments
Search for a Condition or Treatment:
Show Items Starting With: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
View allSearch
Locations
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
Close