Liver Diseases & Causes of Liver Failure 

There are a bunch of liver diseases which might entail the need for a liver transplant. In adults, ESLD or cirrhosis is the primary reason for which a liver transplant is required.

Liver disease covers an array of diseases that can vary in severity. From mild injuries to severe liver cirrhosis, there are several conditions which need immediate medical attention. As a matter of fact, untreated liver injuries prove to be a gateway towards cirrhosis or liver scarring – also termed as end-stage liver disease. Here are some causes of liver cirrhosis

• Hepatitis  (A, B, C, and others) which may affect the functioning of liver cells.

• Wilson’s disease – also termed as a disorder of copper metabolism.

• A genetic defect with a missing enzyme that may result in liver disease – often referred to as Alpha-one anti-trypsin deficiency

• An inherited metabolic disorder known as Glycogen storage disease (type I, III, IV)

• A disorder of tyrosine metabolism referred to as Tyrosinemia

• Alcoholic liver disease along with Drug-induced liver disease which is caused due to excessive consumption of alcohol/drugs causing irrevocable damage to the liver.

• Nonalcoholic fatty liver disease resulting in extra fat in the liver owing to obesity, high levels of cholesterol or triglycerides accumulating in the liver.

• Primary biliary atresia, also known as extrahepatic ductopenia –  a congenital condition where the bile ducts stop forming properly resulting in narrow, blocked, or absent ducts.

• Autoimmune liver diseases – where the immune system stages an attack against the liver

• A condition known as Hemochromatosis which is characterized by excessive iron deposits in the liver

End-stage liver disease (ESLD) or cirrhosis

Cirrhosis is a late-stage liver disease that is caused as a result of sustaining permanent damage or scarring of the liver. When an individual has cirrhosis, it means that the scar tissue (fibrosis) has destroyed or replaced the healthy tissue or liver cells. Over time, when scarring has affected a significant part of the liver, it is a condition which is referred to as cirrhosis.

This scar tissue prevents the liver from working at optimal levels eventually causing loss of liver function.  It needs to be mentioned that even if almost 70 percent of the liver is damaged, the liver has the ability to regenerate and repair itself in just a matter of a few weeks. However, a liver affected from cirrhosis can’t regenerate or re-grow which eventually results in the liver losing its capacity to function properly. Worse still, this is often a progressive condition and usually irreversible as well. What this also means is that no type of medications can reverse or treat this condition. This condition which results in the loss of liver function or organ failure can be described as End-Stage Liver Disease (ESLD).

Liver cirrhosis has also been linked as the biggest risk factor for primary liver cancer (hepatocellular carcinoma), which has rapidly become the leading cause of cancer death across the world. Another issue that arises due to ESLD is the reduction in brain function. This is caused as a result of the build-up of toxins in the blood – owing to the liver not functioning – which can result in confusion. The resulting symptoms can cause irritability and unresponsiveness, eventually spiraling out of control and can even cause the affected individual to slip into a comatose state. Scarring can also prevent the liver from producing enough clotting factors, which can cause bleeding and bruising.

More often than not, liver cirrhosis is a by-product of unhealthy lifestyles, obesity, and aging populations. However, little known causes of cirrhosis include adverse reactions to certain types of medications or long-term exposure to toxins and poisons, such as arsenic. It has also been noticed that cirrhosis can affect some people despite not having an obvious cause.

An individual suffering from cirrhosis may begin to display symptoms of inadequate liver function – a condition described as decompensated liver disease. Although cirrhosis is a deadly condition which is irreversible, if diagnosed at an early stage, seeking early treatment can halt its progression and help stop further damage to the liver from occurring. That being said, medications can only reduce the symptoms and getting a liver transplant is the only viable alternative for people seeking a permanent solution.

Signs and symptoms associated with liver disease

Individuals suffering from cirrhosis might not showcase any symptoms especially in the early stages of cirrhosis. However, with time as the condition worsens, it can cause the following symptoms, including:

• Tiredness or Fatigue

• Loss of Appetite

• Excessive sleepiness

• The buildup of fluid in the abdomen leading to swelling

• Unexplained weight loss

• Easy bruising and bleeding

• Presence of small red spots and appearance of tiny lines on the skin also termed as spider angiomas

• Loss of muscle mass

• A state of constant drowsiness and confusion owing to a build-up of toxins in the gut

• Yellowing of the skin and the eyes as well as dark yellow urine (Jaundice)

• Heavy nosebleeds.

• Severe and constant Itching all over the body

• Swelling from the buildup of fluids in the hands and feet (edema)

• Bleeding as a result of the enlarged veins present in the digestive tract.

• Vomiting of blood and presence of blood in the stools

• Slower processing of alcohol and drugs resulting in increased sensitivity when these substances are consumed.

In the case of individuals suffering from only mild liver damage, these symptoms might not manifest itself and may be in need of medical or endoscopic therapy. If the above symptoms were to occur, it’s termed as decompensation or the failure of an organ. By the time individuals are diagnosed with the above symptoms, it might already be too late. Initial diagnostic tests in cirrhotic patients also reveal the following:

• Elevated levels of bilirubin

• Low albumin levels

• High prothrombin time (international normalized ratio)

• Thrombocytopenia (low platelet count)

Acute or fulminant liver failure

Acute liver failure (ALF) is a rare but a devastating condition which can prove to be life-threatening as well. ALF can cause a sudden, progressive, and severe liver dysfunction over a period of just a few days or week which can culminate into multi-organ failure and eventually death. It can affect an otherwise normal individual and even people without any preexisting liver diseases either. This progresses in the rapid but severe deterioration of the liver – while affecting its functioning – within no time. Early symptoms of ALF need to be closely monitored including the onset of jaundice, a feeling of confusion or drowsiness which eventually results in the individual slipping into a comatose state.

It also needs to be mentioned that patients suffering from ALF can die within days if they do not get a liver transplant unlike individuals suffering from the chronic liver disease who can survive for a longer time-frame while awaiting liver transplantation.

Some diseases which can cause acute liver failure are as follows:

• Liver diseases leading to infections caused by hepatitis A virus (HAV) or hepatitis E virus (HEV)

• Side effects of certain medications such as anti-tubercular drugs, paracetamol & even Ayurvedic medicines

• Acute fatty liver of pregnancy (AFLP)

Fortis Centre for Liver Care & Transplant (CLCT)

At Fortis Centre for Hepatobiliary Sciences and Liver Transplant, the experienced team of liver specialists ensures the best treatment for your liver and the associated organs such as the pancreas, biliary tree and gall bladder. When these organs are afflicted with common diseases including Hepatitis A and B, fatty liver, cirrhosis and even cancer, the hepatologists rise to the occasion to diagnose and treat the diseases in the best possible methods.

The Liver Transplant team comprises highly qualified and skilled hepatologists who are equipped with the agility and precision to conduct liver transplants when this incredibly hardworking organ gives up functioning to its maximum capacity.