Hepatic insufficiency – colloquially called liver failure – (Thesaurus synonyms: Acute yellow liver atrophy; Acute hepatitis with liver failure; Acute liver dystrophy; Acute parenchymal liver degeneration a.n.k. ; Acute liver failure; Chronic yellow liver atrophy; Chronic liver dystrophy; Chronic liver failure; Coma hepaticum; Encephalopathy hepatica; Fulminant hepatitis with liver failure; Yellow liver atrophy; Hepatic decompensation; Hepatic encephalopathy; Hepatic insufficiency; Hepatoencephalopathy; Icterus maligne; Liver atrophy; Liver failure coma; Hepatic dystrophy; Hepatic coma; Hepatic necrosis; Hepatic necrosis with liver failure; Hepatic parenchymal necrosis; Hepatic parenchymal atrophy; Hepatic cell degeneration; Hepatic cell necrosis; Hepatic cell necrosis with liver failure; Malignant hepatitis with liver failure; Portocaval encephalopathy; Praecoma hepaticum; Subacute yellow liver atrophy; Subacute parenchymal liver degeneration a. n.k. ; ICD-10-GM K72.0: Acute and subacute liver failure, ICD-10-GM K72.1: Chronic liver failure, ICD-10-GM K72.9: Chronic hepatitis, unspecified) describes a functional disorder of the liver with partial or complete failure of its metabolic functions. Liver failure is the most severe form of liver insufficiency. This is an acute life-threatening condition. The following forms of liver failure can be distinguished:
- Hyperacute liver failure – there are less than 7 days between onset and encephalopathy (a collective term for pathological (pathological) changes in the brain).
- Acute liver failure (ALV; acute liver failure, ALF) [ICD-10-GM K72.0: Acute and subacute liver failure- between onset and encephalopathy are between 7 and 28 days; fulminant: < 7 days, protracted > 4 weeks
- Severe hepatic dysfunction with icterus (jaundice) and consecutive coagulopathy (INR > 1.5)
- Hepatic encephalopathy (HE; disease or damage to the brain).
- Subacute liver failure (SALV; SALF) [ICD-10-GM K72.0: Acute and subacute liver failure] – more than 28 days (up to 6 months) between onset and encephalopathy.
- Acute-on-chronic liver failure (ACLF) represents acute hepatic decompensation of preexisting chronic liver disease with consecutive organ failure. Short-term survival is very poor and stage-dependent. Triggers are bacterial infections (such as pneumonia/pneumonia, urinary tract infections, or spontaneous bacterial peritonitis (SBP)/ascites (abdominal fluid) infection without the presence of an intestinal lesion (“injury affecting the intestine)), which in this case lead to systemic inflammation (inflammation). It is a relatively new entity.Definiton:
- Presence of acute decompensation.
- Identification of organ failure by objectifiable standards.
- High short-term mortality of more than 15%.
- Chronic liver failure (CLV; CLF) [ICD-10-GM K72.1: Chronic liver failure].
Liver failure can have many different causes. In Europe, hepatitis (liver inflammation) predominates as the main cause; in America, England, and Scandinavia, toxins (poisons) predominate. Sex ratio: Acute liver failure seems to affect women more often than men. Acute liver failure is a relatively rare disease. In Germany, there are approximately 200-500 cases per year. Course and prognosis: The prognosis of acute liver failure depends on several factors: Etiology (cause), previous disease, as well as speed of development of acute liver failure (fulminant (sudden or rapid) is prognostically better than delayed). The most common cause of death is cerebral edema (brain swelling; in 70% of cases). Patients require liver transplantation (LTx) in 50% of cases. The lethality (mortality relative to the total number of people with the disease) in acute liver failure is 50-75%. Patients who survive acute liver failure usually recover completely.
