liver (hepatic) failure/insufficiency

Etiology

• hepatic cirrhosis is the classic example

Pathology

• inability of the liver to produce sufficient proteins for normal homeostatic metabolic processes, including:
  • osmotic pressure (albumin)
  • coagulation
  • drug metabolism

Laboratory

• serum transaminases may be normal
• serum cholesterol is generally low
• INR is elevated
• serum albumin is generally low
• platelet count: thrombocytopenia
• prothrombin time & aPTT may be prolonged
• factor VIII activity may be elevated

Diagnostic procedures

• abdominal ultrasound of liver & spleen

Management

• decrease protein intake to < 1 g/kg/day only if hepatic encephalopathy is present
• fresh frozen plasma corrects coagulopathy
  • short 1/2life of factor VII limits duration of effect
  • also administer vitamin K
• liver transplantation, see cirrhosis

More general terms

• liver disease

More specific terms

• acute liver failure (ALF)
• cirrhosis
• hepatic encephalopathy