Liver failure

Peter Celec

petercelec@gmail.com

www.imbm.sk

Liver failure

• Breakdown of liver functions• Inability of the liver to perform its normal function

• Synthetic and metabolic

• Partial/global

• (de)compensated

• Acute LF – without preexisting liver disease

• Chronic LF – with preexisting liver disease

• Acute on chronic LF – sudden necrotising episode

ALF

ALF

ALF

ALF

ALF

ALF

ALF

• Jaundice

• Hepatic foetor

• Fever

• Changed liver size

• Cerebral edema

• Encephalopathy

• Coagulation disorders

• Bilirubin, liver enzymes, renal failure

ALF

• Complications• MOF

• Neurological (encephalopathy)

• Cardiovascular (hypotension)

• Pulmonary (edema)

• Bleeding (coagulopathy)

• Infections (immunosupression)

ALF

ALF

CLF

• Causes• ALD

• NASH

• Chronic hepatitis B, C

• Primary biliary cirrhosis

• Hemochromatosis

• Wilson's disease

• Cardiac cirrhosis

• Autoimmune hepatitis

• Primary sclerosing cholangitis

CLF

• the liver does not function properly due to long-term damage• Hypogonadism (SHBG)

• Fetor hepaticus• Dimethyl sulfide

• Splenomegaly

Jaundice

Ascites

Spider nevi

Palmar erythema

Gynecomastia

Esophageal varices

Caput medusae

CLF

Scores

Scores

Cirrhosis

Cirrhosis

Cirrhosis

Cirrhosis

Cirrhosis

Portal hypertension

Portal hypertension

Hepatorenal syndrome

ALD

NAFLD

NAFLD

NAFLD

NAFLD

NAFLD

NAFLD

ACLF

ACLF