Acute hepatic failure is the advanced stage resulting from other hepatic complications, generally manifested externally in the jaundice and internally characterized by hepatic encephalopathy and insufficiency of protein synthesis. There are some problems of its exact definition, since its different symptoms manifest themselves with a significant variance among patients, which remains a major obstacle to the correct diagnosis. Quantitatively, a situation characterized by liver cell dysfunction 80-90% is considered a case of acute liver failure (ALF).
Diagnosis and symptoms
The diagnosis of ALF is determined through the examination of clinical cases of patients to verify cases of changes in their brain, coagulopathy, rapidity of onset and if the particular patients presented previous hepatic complications. The main symptoms of ALF include hepatic encephalopathy, which in turn can lead to cerebral edema, which in turn is one of the leading causes of mortality worldwide. Hepatic encephalopathy is a situation characterized by an increase in toxin deposits, such as ammonia and serotonin, in the brain. It inhibits neurotransmission and reception, interferes with blood flow and can lead to major complications of the heart. Hepatic encephalopathy is also difficult to diagnose. In general, doctors try to find more intracranial pressure to confirm it, but it is not a completely reliable indicator.
Another important symptom of ALF is coagulopathy. The liver has a central role in maintaining the level of the coagulates in the body and a typical case of coagulopathy is demonstrated in a patient presenting recurrent events of platelet dysfunction. Even 50% of patients with ALF report kidney failure in their kidneys. In general, patients with ALF report having increased infection rates in various parts of the body, which is logical considering the role of the liver as a “detoxification” organ. Because levels of urea and blood sugar are often abnormal due to liver failure, these sometimes lead to multiple organ failure.
Paracetamol overdoses and excessive alcohol consumption are the main causes of ALF. In children, cases of virulent varicella can also trigger ALF. Even high levels of fatty acids in the blood during advanced stages of pregnancy in women can lead to ALF. Furthermore, it has been noted that the frequency of aspirin use has significant correlations with ALF.
ALF treatments today
Due to the lack of adequate diagnostic provisions, the different symptoms were previously targeted separately, with general prophylactic and medical measures for the liver. Today, the preferred course of treatment is more dramatic and involves a liver transplant. However, this procedure is very expensive and, as the associated complications increase progressively faster, most of the time it is a race against time. However, since liver transplants as a course of treatment were first innovated, ALF mortality rates have decreased. Previous mortality rates were around 80%, while in those cases where patients are receiving liver transplants short-term survival rates have increased dramatically to reach a full 65%.