What is Hepatic Encephalopathy?

Symptoms of Liver Failure

Liver failure occurs if the liver has lost all of its function due to cirrhosis caused by different liver diseases.

What are the common causes of cirrhosis?

  • Hepatitis B & C
  • Alcohol-related Liver Disease
  • Non-alcoholic Fatty Liver Disease (NAFLD) & Non-alcoholic Steatohepatitis (NASH)
  • Autoimmune Hepatitis
  • Bile duct disease such as Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC)
  • Metabolic diseases such as Hemochromatosis, Wilson disease and Alpha-1 antitrypsin deficiency

Liver failure is a life-threatening condition that requires hospitalization. Many people do not have any liver damage symptoms until serious liver problems have already developed slowly and silently.

What are the symptoms and signs of liver failure caused by cirrhosis?
For some people, cirrhosis is diagnosed unintentionally. Cirrhosis often does not have any specific signs and symptoms in the early stage. The non-specific symptoms may be:

  • Nausea
  • Loss of appetite
  • Fatigue
  • Diarrhea
  • Jaundice (yellowing of the skin and whites of the eyes)

As cirrhosis progresses, symptoms and complications can appear that make it apparent that the liver is not doing well. These could be the symptoms of Hepatic Encephalopathy (HE) and other complications due to cirrhosis. In addition to Hepatic Encephalopathy (HE), following complications are signs of liver damage or cirrhosis:

  • Fluid build up and painful swelling of the legs (edema) and abdomen (ascites)
  • Bruising and bleeding easily
  • Enlarged veins in the lower esophagus (esophageal varices) and stomach (gastropathy)
  • Enlarged spleen (splenomegaly)
  • Stone-like particles in gallbladder and bile duct (gallstones)
  • Liver cancer (hepatocellular carcinoma)

Chronic liver failure indicates that the liver has been failing gradually, possibly for years.

If the liver is failing, a liver transplant may be needed in some cases.

What is a liver transplant?
A liver transplant is the process of replacing a sick liver with a donated, healthy liver. Liver transplants require that the blood type and body size of the donor match the person receiving the transplant. Donated livers come from living and non-living donors. Liver transplant surgery usually takes between four and twelve hours. Most patients stay in the hospital for up to three weeks after surgery. There are currently over 17,000 patients waiting for a liver transplant here in the United States. Historically between 5,000 to 6,000 liver transplants happen annually.
In the U.S., there are more people who need a liver transplant than there are donated livers. The major reason for liver transplants here in the U.S. is hepatitis C.

The process to be eligible for a liver transplant is:

  • Person’s doctor refers him or her to be seen at a transplant center;
  • At the transplant center, the transplant team evaluates the person’s overall physical and mental health, plan to pay for transplant related medical expenses, and emotional support family and friends will provide;
  • Based on the findings, the team decides if the person is eligible for a liver transplant;
  • If the person is eligible, the center will add him or her to the transplant waiting list.

The waiting list is prioritized so the sickest people are at the top of the list. The time a person spends on the waiting list depends on:

  • Blood type
  • Body size
  • Stage of liver disease
  • Overall health
  • Availability of a matching liver

Most patients return to a regular lifestyle six months to a year after a successful liver transplant. In some patients, the liver disease they had before the transplant comes back and they may need treatment or another transplant.

For more information about cirrhosis of the liver and liver transplants, call our helpline at 1-800-465-4837 or consult your healthcare provider.

For more information about Hepatic Encephalopathy stages, consult your healthcare provider.