The liver is a large organ that filters toxins from the body and helps to digest food. It also makes proteins that support the immune system and serves other important functions. Liver failure happens when the liver becomes so damaged that it cannot work properly. It can happen in children and adults of any age.

There are two kinds of liver failure:

  • Acute liver failure happens quickly in a child who has no previous liver disease.
  • Chronic liver failure happens over a period of time in a child who has liver disease, such as biliary atresia or hepatitis.

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What are the signs and symptoms of liver failure?

Symptoms of liver failure may include:

  • Pain in the upper right part of the abdomen
  • Jaundice (yellowing of the skin and eyes)
  • Nausea or vomiting
  • Feeling tired
  • Confusion
  • Dark urine
  • Bleeding or bruising easily
  • Itchiness all over the body

Please note there are many conditions that have similar symptoms. It’s important to see your child’s doctor for proper diagnosis and treatment.

What causes liver failure?

The causes of acute and chronic liver failure are different.

Acute liver failure has many causes and can differ by age. Causes may include:

  • Infections or viruses: Epstein-Barr virus, cytomegalovirus, hepatitis A, B or D
  • Drugs or toxins: acetaminophen (Tylenol), poisonous mushrooms, insect or rodent poison
  • Often, the cause of acute liver failure cannot be found.

Chronic liver failure is caused by an illness that has damaged the liver. Some liver conditions that can lead to liver failure include:

  • Biliary atresia
  • Autoimmune hepatitis
  • Metabolic diseases: Wilson disease, alpha-1 antitrypsin deficiency, galactosemia, tyrosinemia or mitochondrial disease

How is liver failure treated?

Treatment will depend on how severe the liver failure is and the cause of liver failure. Children with both acute and chronic liver failure need to be treated in the hospital. Your health care team may discuss both non-surgical and surgical treatment options.

  • Your child’s doctor may wait to see if the liver heals on its own.
  • Supportive care to treat a patient’s symptoms
  • Medicines can sometimes help treat liver failure if it is caused by a medication or toxin, the immune system, or cardiovascular condition
  • In many cases of liver failure, your child may need a liver transplant.
  • The need for liver transplant depends on:
    • If the cause of failure is known
    • If more than one organ or part of the body is affected
    • If there is any brain damage and the chances of it being reversed with transplant
    • If the transplant will be successful

Your child’s health care team will explain the transplant process