Treatment for acute liver failure depends on what caused the disease. Some causes are treatable by either medicine or a liver transplant.
- Supportive care – There are some patients who will get better by themselves if they receive treatment for their symptoms. Many patients whose condition is caused by a virus get better on their own. Their liver is able to reform itself into a healthy organ.
- Medication – When the acute liver failure is caused by a cardiovascular condition or by acetaminophen, it sometimes can be treated with medicine. Medicine may be able to reverse the condition if given early enough.
Metabolic diseases may be treated with medicine or diet if irreversible damage has not yet occurred.
- Transplant – Approximately half of all children with acute liver failure need a liver transplant to survive. For the majority of patients whose cause of liver failure is not known, a transplant is the only option.
A doctor will consider several things when recommending or not recommending a liver transplant, including: the cause of the disease if known, likelihood the transplant will be successful, whether there is a disease in more than one organ or part of the body, the amount of brain damage, and the chances that the brain damage could be reversed once the transplanted liver is working.
One of the challenges of liver transplant for patients with acute liver failure is that liver failure happens quickly and it often takes time to obtain an organ for transplant.
If a transplant is the best treatment option, the doctor and the other members of the patient care team will focus on preventing complications and will treat symptoms while waiting for the donated liver.
- Treating encephalopathy – Hepatic encephalopathy always develops when liver failure occurs suddenly and severely. It is treated by trying to prevent the production of toxic products in the liver, which is what cause the condition.
In severe cases of encephalopathy, cerebral edema (brain swelling) can occur. It often requires a device to be placed on the surface of the brain to monitor the swelling and pressures inside the skull.
Treatment includes the use of mannitol, a sugar compound that helps absorb fluid away from the brain, which decreases the pressure.