Liver failure

A severe deterioration or loss of hepatic function resulting from extensive hepatocellular injury and impaired synthetic, detoxification, and metabolic capacity, often manifesting with coagulopathy, jaundice, hepatic encephalopathy, and multi-organ dysfunction.

Causes

• Acute liver failure causes

  • Drug-induced liver injury: Paracetamol, antibiotics, NSAIDs, statins, amiodarone, valproate, phenytoin, TNF-inhibitors, α-inhibitors, methotrexate

  • Toxin exposure: Poisonous mushrooms (Amanita phalloides)

  • Viral hepatitis: A/B/E

  • Vascular disorders: Budd–Chiari syndrome, Hepatic venous outflow obstruction

  • Pregnancy-related: Acute fatty liver of pregnancy, HELLP syndrome

• Chronic liver failure causes

  • Alcohol-related liver disease

  • Chronic viral hepatitis B/C

  • Metabolic dysfunction-associated steatotic liver disease (MASLD)

  • Autoimmune liver diseases: PSC, PBC, AIH

  • Genetic and metabolic disorders: Hemochromatosis, Wilson disease, Alpha-1 antitrypsin deficiency

  • Advanced malignancy: Infiltrative liver disease

  • Cryptogenic cirrhosis