People with acute liver failure are often treated in the intensive care unit of a hospital in a facility that can perform a liver transplant, if necessary. Your doctor may try to treat the liver damage itself, but in many cases, treatment involves controlling complications and giving your liver time to heal.
Acute liver failure treatments may include:
- Medications to reverse poisoning. Acute liver failure caused by acetaminophen overdose is treated with a medication called acetylcysteine. This medication may also help treat other causes of acute liver failure. Mushroom and other poisonings also may be treated with drugs that can reverse the effects of the toxin and may reduce liver damage.
- Liver transplant. When acute liver failure can't be reversed, the only treatment may be a liver transplant. During a liver transplant, a surgeon removes your damaged liver and replaces it with a healthy liver from a donor.
Your doctor also will work to control signs and symptoms you're experiencing and try to prevent complications caused by acute liver failure. Your care may include:
- Relieving pressure caused by excess fluid in the brain. Cerebral edema caused by acute liver failure can increase pressure on your brain. Medications can help reduce the fluid buildup in your brain.
- Screening for infections. Your medical team will take samples of your blood and urine every now and then to be tested for infection. If your doctor suspects that you have an infection, you'll receive medications to treat the infection.
- Preventing severe bleeding. Your doctor can give you medications to reduce the risk of bleeding. If you lose a lot of blood, your doctor may perform tests to find the source of the blood loss. You may require blood transfusions.
Scientists continue to research new treatments for acute liver failure, especially those that could reduce or delay the need for a liver transplant. While several potential future treatments are in the pipeline, it's important to remember they are experimental and may not yet be available.
Among those being studied are:
- Artificial hepatic assist devices. A machine would do the job of the liver, much like dialysis helps when the kidneys stop working. There are many different types of devices being studied. Research suggests that some, but not all, devices may improve survival. A well-controlled multicenter trial showed that one system, called an extracorporeal liver support system, helped people with acute liver failure survive without a transplant. The treatment is also called high-volume plasma exchange.
- Hepatocyte transplantation. Transplanting only the cells of the liver — not the entire organ — may temporarily delay the need for a liver transplant. In some cases, it could lead to a complete recovery. A shortage of good-quality donor livers has limited the use of this treatment.
- Xenotransplantation. This type of transplant replaces the human liver with one from a nonhuman animal source. Doctors performed experimental liver transplants using pig livers several decades ago, but results were disappointing. However, advancements in immune and transplant medicine have prompted researchers to consider this treatment again. It may help provide support for those waiting for a human liver transplant.
Aug. 29, 2017
- Goldberg E, et al. Acute liver failure in adults: Etiology, clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed March 7, 2017.
- Goldberg E, et al. Acute liver failure in adults: Management and prognosis. http://www.uptodate.com/home. Accessed March 7, 2017.
- Liver wellness. American Liver Foundation. http://www.liverfoundation.org/education/downloads/. Accessed March 7, 2017.
- Ferri FF. Acute liver failure. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed March 7, 2017.
- Bernal W, et al. Acute liver failure. New England Journal of Medicine. 2013;369:2525.
- Bernsten A, et al., eds. Liver Failure. In: Oh's Intensive Care Manual, 7th ed. Philadelphia, Pa.: Elsevier; 2014. https://www.clinicalkey.com. Accessed April 26, 2017.
- Flamm SL, et al. American Gastroenterological Association Institute Guidelines for the Diagnosis and Management of Acute Liver Failure. Gastroenterology. 2017;152:644.
- Roy-Chowdhury N, et al. Hepatocyte transplantation. http://www.uptodate.com/home. Accessed March 24, 2017.
- Cooper DK, et al. Pig liver xenotransplantation: A review of progress toward the clinic. Transplantation. 2016;100:2039.
- Karvellas CJ, et al. Current evidence for extracorporeal liver support systems in acute liver failure and acute-on-chronic liver failure. Critical Care Clinics. 2016;32:439.
- Yin M, et al. Distinguishing between hepatic inflammation and fibrosis with MR elastography. Radiology. In press. Accessed March 24, 2017.
- Carbon tetrachloride. Environmental Protection Agency. https://www.epa.gov/foia/carbon-tetrachlorideox-frequently-asked-question Accessed April 17, 2017.
- Picco M (expert opinion). Mayo Clinic, Rochester, Minn. April 17, 2017.
- Rajan E (expert opinion). Mayo Clinic, Rochester, Minn. April 17, 2017.