Conditions
Acute liver failure
Quick answer
Acute liver failure is the sudden collapse of a previously healthy liver, over days or weeks. Common triggers are paracetamol overdose, hepatitis A or E, and some medicines or herbal products. It causes jaundice, bleeding tendency and confusion. It is an emergency that may need an urgent liver transplant.
Medically reviewed by The Curaventa Team · Last updated 2026-10-24
What this stage or type means
- The liver fails in a person with no known earlier liver disease.
- Clotting is impaired (raised INR) and the brain is affected (encephalopathy).
- It can develop within days (hyperacute) or over a few weeks (subacute).
- Brain swelling is a major danger in fast-moving cases.
- Some livers recover with intensive care alone; others do not.
Treatment options
Intensive care support
Treatment in a liver ICU to protect the brain, kidneys and circulation while waiting to see if the liver recovers.
Antidote or cause-specific treatment
For example N-acetylcysteine after paracetamol overdose, or antivirals for hepatitis B flare.
Emergency liver transplant
When recovery looks unlikely, an urgent living donor transplant can be arranged if a suitable relative is available.
Liver support therapies
Plasma exchange is used at some centres to buy time.
Tests that confirm it
- INR and bilirubin trend
- Ammonia and lactate
- Paracetamol level and viral hepatitis tests
- CT brain if confusion worsens
- Doppler ultrasound of liver vessels
Outlook
Outcome depends heavily on the cause. Paracetamol and hepatitis A cases recover without transplant more often than some other causes. Specialist teams use criteria such as King's College criteria to decide on transplant.
Planning treatment in India
- Do not travel without a doctor's advice; an air ambulance with ICU staff is usually needed.
- Send INR, bilirubin, creatinine, ammonia and a short clinical summary at once so the team can judge urgency.
- A family donor should travel immediately with passport and relationship proof, as legal approval is still required.
- Expect a long hospital stay, and a much longer time in India if a transplant is done.
Questions to ask your specialist
- Is the liver likely to recover without a transplant?
- What is the cause of the liver failure?
- Who can be tested as a donor, and how quickly?
- Is it safe to transfer the patient by air ambulance?
- What are the next 48 hours likely to look like?
Related treatments
Other stages and types
Frequently asked questions
Can the liver recover by itself after acute failure?
Yes, in some cases, especially after paracetamol overdose or hepatitis A. The liver can regenerate if the person survives the critical phase.
How fast can an emergency living donor transplant happen?
It can be arranged within days at experienced centres, but donor tests and approval are still needed. Having documents ready helps.
Can herbal medicines cause liver failure?
Yes. Some herbal and dietary supplements are known causes. Tell the team about everything the patient took.
Medically reviewed by The Curaventa Team. Last updated 2026-10-24. General information, not medical advice. Medical editorial board · Editorial policy · How we get prices
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