2009-11-11 13:49:19 -
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The liver is one of the largest and most complex organs in the body, serving many metabolic functions, such as detoxifying blood by removing alcohol, chemicals and certain drugs and regulating the amounts of glucose, protein, fat and other components that enter the bloodstream. Unlike most other organs, the liver has multiple sections that are responsible for the same tasks
and can regenerate itself by repairing or replacing injured tissue. If tissue in one section is injured by disease or trauma, another section or sections can perform the functions of the injured section indefinitely or until the damage has been repaired. A liver in an otherwise healthy patient that is functioning at a minimal level can typically regenerate itself in one to two weeks to a level that would enable the patient to avoid intensive care therapy, and can generally completely regenerate itself in two to three months. Despite the protections of overlapping functions and tissue regeneration, the liver can fail as a result of disease or damage. Death occurs when approximately 80% to 90% of liver function is lost, depending on the effectiveness of the remaining liver tissue and other factors.
The most common liver diseases are cirrhosis (scarred or hardened liver tissue due primarily to viral or bacterial infection, as well as alcohol abuse), hepatitis (inflammation of the liver, usually as a result of viral infection or alcohol abuse) and cancer. Other causes of liver damage include drug overdoses, metabolic and autoimmune disorders, chemical toxins and trauma. Liver failure can progress extremely rapidly as in Fulminant Hepatic Failure (FHF), or more slowly, as with chronic liver diseases.
The things that can cause acute liver failure include hepatitis virus infections, drugs, pregnancy, autoimmune disease, and sudden low blood flow to the liver. Little is known about how often each of these things is responsible for acute liver failure in the United States.
Fulminant Hepatic Failure (FHF) is a disease condition that develops in the absence of previous liver disease and is varcharacterized by acute hepatic dysfunction with the onset of encephalopathy within two to eight weeks of the onset of jaundice. A patient may enter a state of liver failure by a variety of routes. Prominent among these is viral hepatitis caused by at least three distinct viruses: hepatitis A, hepatitis B and hepatitis C virus. Drug ingestion is also a significant cause of liver failure, with alcohol being the most familiar. Other agents associated with liver failure include many of the most widely used pharmaceuticals. Acetaminophen, taken with suicidal intent, is the single most common cause of fulminant liver failure in Great Britain. Acute fulminant hepatic failure (FHF) continues to be associated with a mortality rate in excess of 50% in spite of advances in medical management and treatment by liver transplantation. Upwards of 25% of patients with FHF are not suitable candidates for liver transplantation and are associated with a mortality rate exceeding 90%. In addition 5-10% of patients who are suitable candidates for liver transplantation expire due to the unavailability of a donor liver.
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