Acute liver failure is a medical emergency that can cause life threatening complications. It’s most commonly caused by drug overdose in the United States, with acetaminophen being the most common responsible medication.

Acute liver failure is a loss of liver function that can occur within days to weeks. It most often occurs due to drug overdose or viral hepatitis. In the United States, the most common cause is acetaminophen (Tylenol) overdose.

In contrast, chronic liver failure develops slowly over many months or years. It’s often linked to high alcohol consumption for many years.

Acute liver failure can cause life threatening complications like multi-organ failure or swelling in your brain. The survival rate tends to be poor without a liver transplant.

Keep reading to learn more about acute liver failure, including symptoms, causes, and treatment options.

Potential early signs and symptoms of acute liver failure can include:

As it progresses, you might develop additional symptoms, such as:

The most common causes of acute liver failure worldwide are viral hepatitis and drug or medication overdose.

In developed countries, acute liver failure is estimated to occur in about 1 to 6 people per 1 million people per year.

Drug-induced hepatitis accounts for half of cases of acute liver failure in the United States, and acetaminophen (Tylenol) overdose is the most common cause. Acute liver failure can onset within days of starting a medication. Some herbal supplements like ephedra have also been linked to acute liver failure.

Less common causes of acute liver failure include:

In many cases, the underlying cause of acute liver failure can’t be determined.

People who take high amounts of acetaminophen have the highest risk of developing acute liver failure in the United States.

Acute liver failure is most common among adults ages 35 to 45 and females have a slightly higher risk than males. Other risk factors include:

  • alcohol misuse
  • poor nutrition
  • malnutrition
  • pre-existing cirrhosis

Acute liver failure can cause life threatening complications, such as:

Acute liver failure can develop rapidly in people with no pre-existing liver disease and requires immediate emergency medical attention.

Medical emergency

Go to the nearest emergency room if you or somebody you’re with develops sudden jaundice or other concerning symptoms like:

  • upper-right abdominal pain
  • confusion
  • other changes in personality or behavior
  • vomiting blood

Doctors can use the following to help diagnose acute liver failure:

Treatment for acute liver failure depends on the underlying cause. An emergency liver transplant is often required where your liver is replaced with a liver from a donor.

Supportive treatment for acute liver transplant may include:

Treatment for acetaminophen overdose

If acetaminophen overdose is suspected, you may receive:

Treatment for other causes

Other potential treatments include:

  • IV methylprednisolone for autoimmune hepatitis
  • N-acetyl cysteine for some other causes like viral hepatitis
  • activated charcoal for some types of poisoning
  • anticoagulation therapy or transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome
  • acyclovir for herpes hepatitis or varicella zoster infection

Acute liver failure tends to have a very poor outlook, although the survival rate has improved with the emergence of emergency liver transplants. The cause of death is often multi-organ failure or swelling in the brain.

The survival rate for people who don’t receive a liver transplant ranges from about 10% to 40%. People who need a liver transplant now have an expected 1-year survival greater than 65%.

You can potentially prevent acute liver failure by:

  • taking your medications as prescribed or recommended and not exceeding the maximum dose
  • avoiding herbal supplements that can cause acute liver failure, such as ephedra and pennyroyal
  • taking precautions against viral hepatitis infection, such as receiving a vaccine before traveling to areas with high rates of viral hepatitis
  • avoiding eating wild mushrooms
  • taking precautions to avoid heatstroke

Here are some frequently asked questions people have about acute liver failure.

Does liver failure happen suddenly?

Acute liver failure, by definition, develops quickly, within days or up to 26 weeks. In contrast, chronic liver failure can develop over months to years.

Can I recover from acute liver failure?

Some people may make a full recovery from acute liver failure. Your chances of making a recovery depend on factors like how quickly you receive treatment and the underlying cause.

How long can you survive with liver failure?

Some people with liver failure go on to live full lives. In general, your outlook is best the quicker liver failure is diagnosed and treated.

The outlook for acute liver failure has improved since the development of liver transplants. Without a liver transplant, most people with acute liver failure pass away.