Therapy | Liver insufficiency – causes and therapy

Therapy

The treatment of liver failure depends on both the cause and the severity of the condition. In some cases, it is acute events such as poisoning that can be remedied by an antidote or measures such as blood plasma separation. Very often, however, an alcohol abuse in the context of alcohol-toxic liver damage or even alcoholic cirrhosis of the liver is to blame for the liver failure.

In such cases, the most important therapeutic measure is a period of abstinence from alcohol. Other causal diseases require special therapeutic measures. For example, in hemochromatosis, bloodletting (drawing large amounts of blood) is the most important treatment, while Wilson’s disease is treated with chelating agents (which form non-resorbable complexes with toxic copper).

It is therefore important to treat the causative disease. Equally important is the clinical and outpatient management of the consequences and symptoms of liver failure and the reduction of liver-damaging influences. Drugs such as amiodarone or other liver toxic influences (alcohol) must be reduced or, if necessary, discontinued.

A balanced diet is also necessary. A protein restriction is not necessary contrary to the old doctrine. If there is a lack of clotting factors, they can be substituted or vitamin K can be given.

Abdominal dropsy and other edemas are treated with diuretics. In case of a pronounced albumin deficiency, albumin can be substituted. If portal hypertension (high blood pressure in the hepatic vein) has occurred as a result of liver insufficiency, it can be reduced with a beta-blocker (e.g. propanolol).

This is important in order to prevent the formation of bypass circulation, which can lead to esophageal varices (varicose veins in the esophagus). Complications such as hepatic encephalopathy (damage or dysfunction of the brain caused by severe liver damage) require either outpatient or inpatient treatment. This depends on the severity of the encephalopathy.

A hepatic encephalopathy is a brain damage caused by ammonia deposits. Circulatory stabilization, the avoidance of factors toxic to the liver and the administration of lactulose (laxative) are of primary importance here. A hepatorenal syndrome, in which kidney failure occurs, requires intensive medical care as well as the administration of terlipressin and albumin.

Acute liver failure in the sense of maximum form of liver insufficiency requires intensive medical care. If the liver insufficiency cannot be reversed by the above measures and the disease has progressed to the point where long-term liver failure occurs, only a liver transplant can be cured. To bridge the time until organ transplantation, alternative procedures such as liver dialysis can be used. However, this is not a permanent solution. These articles may also be of interest to you:

  • The diet in cirrhosis of the liver
  • Liver Transplantation