Acute Liver Failure

80-90% damage of hepatic functional capacity to > liver failure Mortality 80% without transplant ALF= encephalopathy within 6m of initial diagnosis Fulminant liver failure= encephalopathy within 2w of jaundice Sub-fulminant liver failure= encephalopathy within 3m Caused by massive hepatic necrosis Most often drug induced: o Paracetamol 50% o Halothane, antimycobacterials (rifampicin, isoniazid), MAOis, carbontetrachloride chemicals, deathcap mushrooms o HepA, HepB, Autoimmune Hep

Chronic Liver Failure

Liver Failure General

Clinical Features: Jaundice + pruritis Hypoalbuminaemia- peripheral oedema, leuconychia Hyperammoniemia- derebral dysfunction Fetor hepaticus Impaired oestrogen metabolism > hyperoestrogenaemia- palmar erythema, spider naevia hypogonadism, gynaecomastia Coagulopathy- bruising, bleeding Complications: Hepatic encephalopathy Hepatorenal syndrome- renal failure Hepatopulmonary syndrome- hypoxaemia, intrapulmonary vascular dilations