Liver failure is when the liver is losing or has lost all of its function. It is a life threatening condition that requires immediate medical care.

The liver has many functions. The most important of these include producing bile, storing glycogen, and removing toxins from the bloodstream.

Liver failure can be chronic or acute. In people with acute liver failure, the liver rapidly loses its function. In those with chronic liver failure, the liver loses function over a longer period.

In this article, we look at both acute and chronic liver failure in more detail, including the stages of liver disease and its causes, symptoms, treatment, and prevention.

one of the liver failure stages, cirrhosis, under a microscopeShare on Pinterest
A cross section cut of liver cirrhosis under a microscope Image credit: klickit24/Getty Images

It is important to understand the difference between liver disease and liver failure. Liver disease refers to any condition that causes damage to the liver and may affect its function.

Liver failure is the term for the liver losing some or all functionality. Liver disease can often result in liver failure.

According to the American Liver Foundation, liver disease may go through a series of stages that can ultimately lead to liver failure.


During the early stages of liver disease, a person may experience inflammation of the liver.

It is common not to feel any discomfort during the inflammation stage and not to notice any other symptoms.

However, without treatment, the inflammation may remain, and it can start to cause permanent damage to the liver.


Without treatment, scarring may start to develop on the inflamed liver. Excessive buildup of scar tissue on the liver is called liver fibrosis.

Over time, excess scar tissue replaces the healthy liver tissue. As scar tissue begins to build up, the liver may not function as well as it previously did. Additionally, the scar tissue can stop blood from flowing through the liver.

If a person seeks medical attention and treatment at this stage, there is still a possibility that the liver will be able to heal.


At this stage, hard scar tissue replaces the liver’s soft, healthy tissue. It is at this stage that people typically begin to notice symptoms.

Cirrhosis can potentially lead to a few complications, including liver cancer.

Without treatment, cirrhosis can worsen. As a result, the liver may stop working properly or at all.

Although treatment may stop or delay liver damage, it is not possible to reverse cirrhosis.

End stage liver disease (ESLD)

At this point, a person’s liver function has deteriorated to such an extent that unless they undergo a liver transplant, their condition will be fatal.

Some doctors may also refer to ESLD as chronic liver failure. The average survival rate of people with ESLD depends on the symptoms and complications that the individual experiences.

People who develop ascites, a buildup of fluid in the abdomen, have a median survival rate of 6 months if it does not respond to treatment.

ESLD also leads to complications, such as hepatic encephalopathy, which affects brain function. In cases where treatment proves ineffective for this condition, the average survival rate is 12 months.

The causes of acute and chronic liver failure differ.

In some cases, the cause of liver failure can be unknown.

Acute liver failure

Possible causes of acute liver failure include:

  • Drug overdose: Overdosing on certain medications, such as acetaminophen, may lead to acute liver failure.
  • Wilson’s disease: In those with this genetic condition, large amounts of copper accumulate in the body.
  • Reye’s syndrome: This condition typically affects children recovering from a viral infection. It causes swelling of the liver and brain. A 2018 case study notes that as well as aspirin, certain flu strains may lead to Reye’s syndrome.
  • Acute fatty liver of pregnancy: This rare condition occurs in the third trimester of pregnancy if the cells do not break down fatty acids. This dysfunction causes fat to accumulate in the liver and other organs.
  • Budd-Chiari syndrome: In this rare disorder, the veins of the liver narrow or become blocked.

Chronic liver failure

A common cause of chronic liver failure is alcohol-related liver disease, which results from a person drinking excessive amounts of alcohol over a long period. Alcohol is responsible for almost half of deaths due to cirrhosis in the United States.

Another cause is nonalcoholic fatty liver disease (NAFLD). This umbrella term encompasses a range of conditions that cause high levels of fat to accumulate in the liver. People are at higher risk of NAFLD if they have obesity, high cholesterol, or type 2 diabetes.

Acute and chronic

Without treatment, hepatitis can lead to acute or chronic liver failure. According to the American Liver Foundation, hepatitis C is among the most common causes of liver cirrhosis.

Exposure to certain toxic chemicals may also cause either acute or chronic liver failure.

Acute liver failure is a medical emergency, and a person should seek medical attention immediately if they experience the following symptoms:

  • diarrhea
  • nausea
  • discomfort on the right side of the body, just below the ribs
  • confusion
  • fatigue
  • a buildup of fluid in the abdomen
  • vomiting blood

Chronic liver diseases occur more slowly than acute ones. Initially, a person may not experience any symptoms.

However, as the disease progresses, a person may begin to show the following early symptoms:

People experiencing the more advanced stages of liver diseases may have the following symptoms:

Treatment for liver disease is likely to vary, depending on the stage and underlying cause of the disease.

If a person receives treatment at the inflammation or fibrosis stage, there is a possibility that the liver can reverse the damage.

However, treatment for the later stages of liver disease can only stop it from worsening, with the aim of prolonging life.

Possible treatments for people who experience chronic or acute liver disease include:

  • Antiviral medications: If the cause of the liver disease is viral hepatitis, a person may require antiviral medications.
  • Immunosuppressing medication: This type of medication is necessary for people experiencing immune hepatitis.
  • Lifestyle choices: When the cause of the liver disease is related to alcohol or obesity, a doctor may advise the person to stop drinking or try to lose weight.
  • Liver dialysis: A person in the later stages of liver disease may require liver dialysis. This process attempts to remove the toxins from the bloodstream, which the liver is unable to do.
  • Liver transplant: In cases of ESLD, a person may require a liver transplant. This procedure is extremely complex and relies on the availability of a suitable donor.

A person can minimize their risk of developing liver disease by:

  • reaching or maintaining a moderate weight
  • avoiding excessive alcohol consumption
  • completing the hepatitis vaccination schedule
  • following the dosages that a doctor recommends, if taking medication
  • engaging in regular physical activity

If a person seeks medical treatment within the early stages of liver disease and adopts a healthful lifestyle, their liver might be able to heal from any previous damage.

However, once a person is in the cirrhosis stage of liver disease, the damage becomes irreversible. Treatment during this stage is usually to stop the damage from worsening and prolong a person’s life.

Liver failure occurs when the liver is no longer able to function.

It can sometimes occur rapidly in people with no preexisting liver disease, or it may develop over a long period.

Treatment options vary depending on the cause and stage of the disease.

A person can reduce the risk of developing liver diseases that may lead to liver failure by making lifestyle adjustments and getting certain vaccinations.