|Classification according to ICD-10|
|K72.0||Acute and subacute liver failure|
|ICD-10 online (WHO version 2019)|
As liver failure or liver insufficiency termination or acceptance will be referred to a plurality or all liver functions. It is the result of acute or chronic liver disease. In a narrower sense, liver failure refers to acute liver failure (ALV) . It is a rare but life-threatening clinical picture with sudden loss of liver function without pre-existing liver disease, characterized by the clinical triad of jaundice ( jaundice ), plasmatic coagulation disorder ( coagulopathy ) and impaired consciousness ( encephalopathy ). Depending on the timing of the encephalopathy, a distinction is made between hyperacute , acute and subacute liver failure . The most common causes of ALV worldwide are viral hepatitis , paracetamol intoxication and other drug-related reactions. ALV must be differentiated from acute-on-chronic liver failure (ACLF) in patients with pre-existing liver cirrhosis .
A decrease in liver function up to liver failure can be acute in the context of z. B. poisoning or circulatory disorders of the liver as well as chronic liver diseases such as cirrhosis occur.
The main causes of acute or subacute liver failure are accidental poisoning or poisoning with suicidal intent with liver-damaging substances ( e.g. paracetamol ) and toxins such as those of the death cap ( amatoxins , phallotoxins ) or acute vascular occlusions ( portal veins , liver veins ).
Chronic liver failure is caused by diseases that permanently damage the liver, such as chronic hepatitis B and C, alcohol abuse or chronic vascular diseases that lead to liver failure via liver cirrhosis.
Liver failure is characterized by a decrease in the synthesis and detoxification functions.
- Jaundice (jaundice)
- hepatic encephalopathy up to hepatic coma
- hepatorenal syndrome (kidney failure due to liver failure)
- Disorders of blood clotting
- Hypoalbuminemia with ascites
- endocrine disorders (disorders of the hormonal system )
The course of acute liver failure is characterized by the cause and depending on the treatment of the underlying disease such as removal of toxins (paracetamol, mushroom poisoning) or restoration of blood circulation.
The prognosis of chronic liver failure depends on the progression of the underlying disease.
When acute-on-chronic liver failure (ACLF) occurs, e.g. B. due to an additional circulatory disorder or viral hepatitis with existing liver cirrhosis, the prognosis is unfavorable.
- Ali Canbay et al .: Acute Liver Failure : A Life -threatening Disease . In: Dtsch Arztebl Int . No. 108 (42) , 2011, pp. 714-720 ( review ).
- ↑ Gerd Herold and colleagues: Internal Medicine 2020. Self-published, Cologne 2020, ISBN 978-3-9814660-9-6 , p. 558.
- ↑ See Hans Adolf Kühn: diseases of the liver. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 847-875, here: pp. 861-863 ( acute and subacute liver dystrophy ).
- ↑ Doctors' newspaper: ACLF with poor prognosis,  , from July 19, 2016, accessed on June 12, 2020