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August 10,2019
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What Are The Different Stages Of Liver Failure?

Liver failure occurs when large parts of the liver become damaged beyond repair and the organ fails to work at the optimum level. Although the liver performs over 500 bodily functions, it’s vital tasks being the purification of blood and the production of bile to digest the food. When these two functions encounter problems, the situation can be life-threatening.

Liver failure can be categorized into two types, acute and chronic. Acute liver failure occurs rapidly, while chronic liver failure happens gradually over time. There are several stages of liver failure, where each step progressively hampers the functioning of the liver.


1) Inflammation

During the early stages of liver failure, there is an inflammation or enlargement of the liver. The swelling is a response to the body fighting an infection or trying to heal an injury. It is important to note that people having inflammation in the liver doesn’t necessarily experience the symptoms.

2) Fibrosis

When an inflamed liver is untreated, it begins to scar. When the excess scar tissue grows, it gradually replaces the healthy liver. The process is called Fibrosis. The scar tissue fails to do the work of a healthy liver. It also prevents the blood from flowing through the liver. There is still a chance of recovery at this stage if the liver disease is diagnosed without any delay.

3) Cirrhosis

Cirrhosis of the liver happens when there is irreversible scarring in the liver. The liver has to work hard for executing its normal functions. The symptoms of liver diseases usually manifest at this stage. Liver Cirrhosis is generally the prime reason for liver cancer in patients.

4) Liver Cancer

Cancer is a group of disease that involves the development and multiplication of abnormal cells. Even though liver cancer can occur at any stage of liver damage, the risk is the highest in people having liver cirrhosis. Primary liver cancer is the one which starts in the river. Cancer that spreads to the liver from some other organ is called metastatic liver cancer.

5) End-stage liver disease (ESLD)

Patients suffering from end-stage liver disease has their liver function ceased almost entirely. End-stage liver disease is also termed as chronic liver failure. ESLD is often associated with problems like ascites and hepatic encephalopathy. The condition of the liver during ESLD can’t be reversed other than a liver transplant.


Acute liver failure can be caused due to several issues and is difficult to judge sometimes. However, there are some possible causes of acute liver failure that are commonly seen. Some of them are:

  • Viral infections like Hepatitis A, B or E.
  • Acetaminophen(Tylenol) overdose
  • Adverse reaction from anti-biotics or anti-epileptic drugs
  • Exposure to toxins that are found in industrial chemicals or poisonous wild mushrooms.

Chronic liver failure happens over a considerable amount of time and the following are the main causes.

  • Chronic hepatitis B or C infection
  • Non-alcoholic fatty liver disease
  • Autoimmune Hepatitis
  • Diseases that impact bile ducts, such as cholangitis


Acute liver failure occurs in people who don’t have a preexisting liver condition. It is considered as a medical emergency where the patient should be given the treatment at the earliest. The symptoms of Acute Liver Failure involves:

  • Feeling tired or sleepy
  • Experiencing Nausea and Vomiting
  • A feeling of confusion and disorientation
  • Abdominal pain or swelling


As chronic liver failure is a gradual process, there are early symptoms as well as advanced symptoms to it. The early signs of chronic liver failure involve:

  • Quickly bruising or bleeding
  • Yellowing of eyes and skin ( Jaundice)
  • Persistent skin itching
  • Darkening of urine


For diagnosing liver failure, doctors will start by taking a medical history and then performing a physical examination. Doctors shall then conduct some additional tests that include:

Liver Function Test: This liver function test helps to determine the levels of proteins and enzymes in the blood that are vital indicators of liver function.

Some Other Blood Tests: Additional blood tests like complete blood count (CBC) or test for viral hepatitis helps to check genetic factors that

Imaging Tests: Imaging techniques like ultrasound, CT scan, or MRI scan helps doctors to get a clear picture of the liver.

Tissue Analysis (Biopsy): Removing a sample of tissue from the liver helps doctors to see signs of liver damage.


As the liver failure is often caused by direct damage happening to the liver, the treatment involves the identification of the issues. For instance, the treatment of viral hepatitis is usually done by providing anti-viral medications to patients. Likewise, for treating autoimmune hepatitis, immune-suppressing medication is administered.

In patients with severe cirrhosis and end-stage-liver diseases, liver transplant surgery might be needed. It is a medical procedure that involves the replacement of a diseased liver with a healthy liver from another person.

It is a matter of grave concern that patients often do not get the liver transplantation done due to lack of accessibility and affordability. Also, for a complex surgery like this, there is no room for any delay.

The Praveen Agarwal Foundation (TPAF) is a philanthropic organization that is driven to make liver transplant surgery across India more affordable, accessible and available. They join hands with healthcare NGO’S, liver transplant surgeons, hepatologists and hospital management for carrying out the liver transplantation, both pediatric and adult. Since its inception in 2006, TPAF has helped families of more than 100 children who needed a liver transplant. They have also managed to raise funds worth more than INR 7.5 Crore from over 10,000 donors from crowdfunding platforms and partnered with the best hospitals in India.

As the liver plays a significant role in almost all of the bodily functions in humans, its health is of supreme importance. By being aware of the causes and symptoms of various liver diseases, one can effectively take measures in safeguarding the health of their largest internal organ.

You can also Join Our TPAF Facebook Group – The Pravin Agarwal Foundation (TPAF) Support group, created to form a network of families/caregivers of children who suffer from Liver Disease. We would request to join the platform to share experiences & concerns, provide emotional & social support and encourage one another in this journey.

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