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Acute liver failure is the appearance of severe complications rapidly after the first signs (such as jaundice) of liver disease, and indicates that the liver has sustained severe damage (loss of function of 80–90% of liver cells).
The name is derived from the fact that the cells undergoing this form of cell death increase in size . It is generally considered a form of apoptosis , [ 1 ] and is a descriptor used in the context of inflamed fatty liver ( steatohepatitis ) [ 2 ] (which may be due to obesity or alcohol ), as well as viral hepatitis.
Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [ 1 ] Recently, a third form of liver failure known as acute-on-chronic liver failure ( ACLF ) is increasingly being recognized.
Macroscopically, the liver has a pale and spotty appearance in affected areas, as stasis of the blood causes pericentral hepatocytes (liver cells surrounding the central venule of the liver) to become deoxygenated compared to the relatively better-oxygenated periportal hepatocytes adjacent to the hepatic arterioles.
The main liver cells are called hepatocytes; however, there are other cells that can be observed in a liver sample such as Kupffer cells (macrophages). [2] The liver is the biggest gland of the body. It has a wide variety of functions that range from the destruction of old blood cells to the control of the whole metabolism of macromolecules . [ 3 ]
Other causes include: infiltrative liver diseases, granulomatous liver disease, abscess, amyloidosis of the liver and peripheral arterial disease. Mild elevation of ALP can be seen in liver cirrhosis, hepatitis, and congestive cardiac failure. Transient hyperphosphataemia is a benign condition in infants, and can reach normal level in 4 months.
Focal fatty liver (FFL) is localised or patchy process of lipid accumulation in the liver. [1] It is likely to have different pathogenesis than non-alcoholic steatohepatitis which is a diffuse process. FFL may result from altered venous flow to liver, tissue hypoxia and malabsorption of lipoproteins.
Gilbert's syndrome, a genetic disorder of bilirubin metabolism found in a small percent of the population, can cause mild jaundice. [14] Cirrhosis is the formation of fibrous tissue in the place of liver cells that have died due to a variety of causes, including viral hepatitis, alcohol overconsumption, and other forms