Acute Liver Failure Treatment in Gurgaon, India
What is Acute Liver Failure?
Acute liver failure (ALF) is a life-threatening condition in which the liver suddenly loses its ability to function properly. Unlike chronic liver diseases, where liver damage builds up over time, ALF occurs rapidly, often within a span of days or weeks. The liver is a crucial organ that plays several key roles in the body. It detoxifies harmful substances in the blood, produces proteins that help with blood clotting, aids in digestion through bile production, and stores important nutrients like glycogen. When the liver suddenly stops working, its inability to carry out these essential tasks can lead to a cascade of serious health problems, some of which can be fatal. The failure of the liver disrupts many bodily functions, causing a range of complications that require immediate medical attention
What Causes Acute Liver Failure?
Acute liver failure (ALF) occurs when the liver suddenly loses its ability to perform its essential functions. There are many potential causes, ranging from toxin exposure to infections and underlying medical conditions. Below, we’ll explore the main causes of acute liver failure in more detail:
Acetaminophen Overdose (Tylenol)
Acetaminophen is one of the most common over-the-counter pain relievers. While it’s generally safe when taken as directed, an overdose can lead to severe liver damage. This happens because acetaminophen is metabolised by the liver, and when taken in excessive amounts, it produces harmful byproducts that overwhelm the liver’s detoxification system. This damage can lead to acute liver failure within just a few days if untreated.
Taking too many pills, especially when combined with alcohol or other medications, increases the risk.
Nausea, vomiting, and loss of appetite, often occurring within hours of ingestion, followed by liver damage symptoms like jaundice and confusion.
Hepatitis and Other Viruses
Hepatitis viruses especially Hepatitis A, B, and E are common causes of acute liver failure. These viruses attack the liver and cause inflammation, which can quickly progress to liver damage and failure if not treated properly.
Hepatitis A: Often transmitted through contaminated food or water, can cause sudden liver failure, especially in adults.
Hepatitis E: infection is usually caused by contaminated water and through contaminated food. Infection is particularly severe in pregnant women. Acute fever field caused by hepatitis E is much more severe and has a higher incidence of complications as compared to hepatitis A induced liver failure.
Hepatitis B and C: While these types are typically associated with chronic liver disease, acute infections in certain individuals can lead to rapid liver failure. Hepatitis B can be passed through bodily fluids (like blood and sexual contact), while Hepatitis C is primarily spread through blood.
Certain Prescribed Medications
Certain prescription drugs, especially when taken improperly or in high doses, can cause liver toxicity and lead to acute liver failure. Some of the common medications associated with liver damage include:
Antibiotics: Medications like amoxicillin-clavulanate (Augmentin) and isoniazid (for tuberculosis) can harm the liver.
Anti-seizure drugs: Medications like valproic acid and phenytoin may contribute to liver injury.
Painkillers: In addition to acetaminophen, drugs like ibuprofen and other NSAIDs, when used long-term or in excessive amounts, may also damage the liver.
Statins: Cholesterol-lowering medications, such as atorvastatin, can cause liver problems in some people.
Toxins and Chemicals
Chemical exposure or toxin ingestion can directly damage liver cells. Common sources of toxins that can cause acute liver failure include:
Industrial chemicals: Solvents, pesticides, and other chemicals used in manufacturing can lead to liver damage upon exposure.
Mushrooms: Certain wild mushrooms, such as Amanita phalloides (death cap), contain toxins that can severely damage the liver and cause acute liver failure.
Alcohol: Chronic and excessive drinking can lead to cirrhosis and liver failure. However, even a single binge drinking episode can trigger acute liver damage in some individuals.
Autoimmune Diseases
In autoimmune diseases, the body’s immune system mistakenly attacks its own tissues. Autoimmune hepatitis is one such condition, where the immune system targets the liver, causing inflammation and damage. This can lead to acute liver failure, particularly if the condition is severe and untreated.
Symptoms: Jaundice, abdominal pain, fatigue, and swelling.
Treatment: Autoimmune hepatitis is usually treated with immunosuppressive medications to reduce immune system activity.
Metabolic Diseases
Metabolic diseases can cause the liver to malfunction and lead to acute liver failure, often due to an abnormal buildup of substances that the liver cannot properly process. Some metabolic disorders include:
Wilson’s Disease: A rare genetic disorder where copper builds up in the liver, brain, and other organs. The buildup of copper can lead to acute liver failure, especially during periods of liver stress or trauma.
Hemochromatosis: A condition where excess iron accumulates in the liver and other organs, potentially leading to liver failure over time.
Other metabolic diseases, such as non-alcoholic fatty liver disease (NAFLD), can also cause liver failure when complications arise.
Cancer
Liver cancer, or hepatocellular carcinoma (HCC), can sometimes cause the liver to fail. This is particularly true in advanced stages of liver cancer, where the tumor may block blood flow to the liver or disrupt liver function completely.
Primary liver cancer: Arises directly in the liver cells.
Secondary liver cancer: Occurs when cancer spreads to the liver from other organs, such as the colon, breast, or lungs.
Cancer-related liver failure typically occurs in people who have existing liver disease, such as cirrhosis or hepatitis.
Shock
Shock occurs when the body’s organs do not get enough blood and oxygen, causing them to stop functioning properly. Severe low blood pressure (hypotension) can cause a sudden decrease in liver function, as the liver is not receiving enough oxygenated blood to carry out its functions. This can result in acute liver failure.
Common causes of shock include:
Trauma or injury: Significant blood loss from accidents.
Severe infections (sepsis): When the body responds to an infection, blood pressure can drop drastically.
Heart failure: When the heart cannot pump blood efficiently to organs, including the liver.
In these cases, the liver cells are deprived of oxygen and nutrients, causing them to fail.
Heat Stroke
Heat stroke occurs when the body overheats and can no longer regulate its temperature, usually due to prolonged exposure to high temperatures or physical exertion in hot environments. This can lead to multiple organ failures, including the liver.
Why it affects the liver: Heat stroke can cause extensive cellular damage, including to liver cells. The liver becomes overwhelmed by the toxic buildup of heat-related stress and inflammation, leading to acute liver failure in severe cases.
People who are dehydrated or have underlying health conditions are more vulnerable to heat stroke. Immediate cooling and medical treatment are crucial to prevent organ damage.
What are the Symptoms of Acute Liver Failure?
Acute liver failure (ALF) is a rapid decline in liver function, usually in a person without pre-existing liver disease. It can develop within days or weeks and is a medical emergency. Below is a more detailed explanation of the symptoms of acute liver failure, what they indicate, and why they occur:
Yellowing of the Skin and Eyes (Jaundice)
What it is: A yellow discolouration of the skin and sclera (white of the eyes).
Why it happens: The liver normally processes and clears bilirubin (a yellow pigment produced from the breakdown of red blood cells). In liver failure, bilirubinbuilds up in the blood because the liver can't process it effectively.
Swelling in the Abdomen (Ascites)
What it is: A buildup of fluid in the abdominal cavity, causing visible swelling and discomfort.
Why it happens: A failing liver can no longer produce enough albumin, a protein that helps maintain fluid balance in blood vessels. As a result, fluid leaks into the abdomen. Also, increased pressure in the liver’s blood vessels (portal hypertension) contributes to this fluid accumulation.
Confusion or Disorientation (Hepatic Encephalopathy)
What it is: Changes in mental function, ranging from mild confusion to coma.
Why it happens: When the liver fails, toxins such as ammonia build up in the bloodstream and affect brain function, leading to confusion, difficulty concentrating, agitation, or drowsiness.
Nausea and Vomiting
What it is: A common digestive symptom that may precede or accompany liver failure.
Why it happens: Liver dysfunction can disrupt the metabolism and cause gastrointestinal symptoms. Also, the accumulation of toxins in the blood may trigger nausea and vomiting.
Severe Fatigue
What it is: An overwhelming sense of tiredness that doesn’t improve with rest.
Why it happens: The liver is essential for energy metabolism. When it fails, the body struggles to generate energy from nutrients, and toxins build up, contributing to physical and mental exhaustion.
Bleeding Easily or Bruising
What it is: Minor bumps cause bruises, or you may bleed more than usual from cuts, gums, or nose.
Why it happens: The liver produces clotting factors necessary for blood coagulation. In acute liver failure, production of these factors drops dramatically, increasing the risk of bleeding
Acute Liver Failure Risk Factors
Acute liver failure happens when the liver rapidly loses its ability to function—often in a matter of days or weeks. Certain individuals are more susceptible to ALF due to underlying health issues, lifestyle factors, or medication use. Understanding these risk factors can help with early detection and prevention.
Overuse of Alcohol
Chronic heavy alcohol use damages liver cells, leading to conditions like alcoholic hepatitis or cirrhosis. If the liver is already compromised, a sudden injury (e.g., infection, medication toxicity) can push it into failure more easily.
High-risk behaviours: Binge drinking, daily heavy drinking, or long-term alcohol use disorder.
Having a Liver Disease Like Hepatitis
Chronic hepatitis B or C weakens the liver over time. Hepatitis A, B, or E can also lead to fulminant hepatitis, a form of ALF, especially in people with weakened immune systems or co-infections.
Autoimmune hepatitis or fatty liver disease (NAFLD/NASH) also increase the risk of sudden liver deterioration under stress.
Taking Certain Medications or Toxins
Some drugs are hepatotoxic, meaning they can damage the liver, especially in high doses or in sensitive individuals.
Antibiotics, anticonvulsants, NSAIDs, statins, and certain herbal supplements can cause liver toxicity.
Illicit drugs like ecstasy (MDMA) and inhalants.
A History of Liver Damage or Liver Transplant
Individuals with prior liver injury or scarring (fibrosis or cirrhosis) have reduced liver reserve. If a new insult (e.g., infection or drug reaction) occurs, their liver may not be able to cope, tipping them into ALF.
Transplant recipients may also be at risk due to immune suppression, infections, or rejection of the graft.
Being Older or Having Other Health Problems
Age: As people age, liver function can gradually decline, and the body becomes less efficient at processing toxins and medications.Other illnesses: Conditions like diabetes, heart failure, kidney disease, or HIV can worsen liver stress or complicate treatment.
Older adults may also have multiple medications (polypharmacy), increasing the chance of liver-toxic drug interactions.
How is Acute Liver Failure Diagnosed?
Diagnosing acute liver failure involves a combination of clinical evaluation, laboratory tests, and imaging studies. The goal is to assess how well the liver is functioning, identify the cause of the failure, and determine the extent of damage. Because ALF can progress rapidly, prompt and accurate diagnosis is critical.
Blood Tests
Blood tests are the most essential and immediate tools for diagnosing ALF.Key blood tests include:
Liver function tests (LFTs)
Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST): High levels suggest liver cell injury.
Alkaline phosphatase (ALP) and Gamma-glutamyl transferase (GGT): Help detect bile duct issues.
Bilirubin: Elevated levels cause jaundice and indicate liver dysfunction.
Clotting tests
Albumin
Ammonia levels
Blood glucose:
Complete blood count (CBC) and kidney function tests
Toxin screening and viral serologies
Imaging Tests
Imaging helps rule out structural abnormalities or other causes of liver dysfunction. Common imaging tools:
Abdominal Ultrasound:
Quick and non-invasive.
Detects liver size, texture, blood flow, and presence of tumors, cysts, or blocked bile ducts.
Can guide procedures like liver biopsy.
CT (Computed Tomography) Scan
Provides a more detailed image than ultrasound.
Useful if ultrasound results are unclear or if bleeding, tumors, or abscesses are suspected.
MRI (Magnetic Resonance Imaging):
Liver Biopsy
In some cases, a liver biopsy may be required to confirm a diagnosis or understand the underlying cause.
A small sample of liver tissue is taken (usually through a needle) and examined under a microscope.
Liver biopsy is done to assess the degree of inflammation, fibrosis (scarring), or fat accumulation and identify conditions like autoimmune hepatitis, Wilson’s disease, or drug-induced liver injury.
How is Acute Liver Failure Treated?
Acute liver failure is a medical emergency that requires urgent hospitalization, often in an intensive care unit (ICU). Treatment focuses on:
Reversing the underlying cause, if possible
Supporting vital functions while the liver heals or until a transplant can be performed
Preventing complications such as brain swelling, bleeding, and infections
Medications to Reverse Poisoning or Specific Causes
When acute liver failure is caused by a toxin, drug overdose, or treatable infection, medications can sometimes stop or reverse the damage.
NAC is highly effective in Acetaminophen (paracetamol) overdose if given early (ideally within 8–10 hours of overdose). NAC may also be used in other forms of liver failure due to its protective effects.
Mushroom poisoning (e.g., Amanita phalloides): Silibinin, penicillin G, or activated charcoal may be used to limit toxin absorption and protect the liver.
Autoimmune hepatitis: Treated with corticosteroids to reduce immune system attack on the liver.
Hepatitis B virus: Antiviral medications (e.g., tenofovir or entecavir) can reduce viral replication.
Wilson’s disease (copper overload): Chelating agents like penicillamine or trientine may be used to bind and remove excess copper.
Supportive Care (ICU Management)
While the liver attempts to recover or until a transplant can be arranged, doctors use supportive care to manage symptoms and prevent life-threatening complications.
Key supportive measures:
Monitoring and correcting blood clotting problems
Treating hepatic encephalopathy (confusion, coma)
Maintaining blood pressure and kidney function
Preventing and treating infections
Nutritional support
Liver Transplantation
A liver transplant is the definitive treatment for patients with severe or irreversible liver failure.
When it's needed
If the liver cannot recover on its own or if the patient meets criteria for transplantation (e.g., based on King’s College Criteria).
Common in cases of fulminant hepatic failure, where death is likely without transplantation.
When is a Liver Transplant Needed in Acute Liver Failure?
Doctors recommend a liver transplant in acute liver failure (ALF) when the liver cannot heal itself and medical treatments stop working. If the liver fails to regenerate after an injury or illness, and vital functions shut down, a transplant becomes the only life-saving option.
Why Do Doctors Choose Transplantation?
The liver performs many essential tasks, like:
Removing toxins from the blood
Producing proteins for blood clotting
Storing energy and regulating glucose
Supporting the immune system
When the liver stops doing these jobs and shows no signs of recovery, doctors act quickly. They consider a transplant to prevent permanent brain damage, organ failure, or death.
When do Doctors Consider a Liver Transplant?
Doctors use specific signs and lab results to decide when a liver can’t recover. The King’s College Criteria helps guide this decision.
Doctors consider a transplant when:
The INR rises above 6.5, showing that the liver can’t make clotting proteins
The patient’s confusion or coma worsens (grade III or IV encephalopathy)
Bilirubin levels rise, indicating severe liver damage
Kidney function declines, with rising creatinine
The patient shows no improvement within 3 to 7 days, even with intensive care
The liver fails due to conditions with poor outcomes, like Wilson’s disease or drug-induced
What are Possible Complications of Acute Liver Failure?
Acute liver failure (ALF) is a life-threatening condition that affects many parts of the body, not just the liver. Without prompt treatment, it can lead to serious complications, some of which can be fatal. Let’s look at each one more closely:
Bleeding and Clotting Problems
The liver produces most of the proteins your body needs to stop bleeding (called clotting factors). When the liver stops functioning, these proteins aren't made properly. It can cause:
Easy bruising
Bleeding gums or nosebleeds
Internal bleeding, such as in the stomach or intestines
Dangerous bleeding during medical procedures or surgery
Infections
Acute liver failure weakens the immune system. The liver normally filters bacteria and helps fight infections. When it fails, the body can’t defend itself as well. Common infections include:
Kidney Failure (Hepatorenal Syndrome)
When the liver fails, toxins like ammonia and bilirubin build up in the blood. These toxins can damage the kidneys. Also, poor blood flow and low blood pressure can stress the kidneys further. It leads to:
Brain Swelling (Hepatic Encephalopathy)
The liver normally clears toxins like ammonia from the blood. In liver failure, these toxins reach the brain. It can lead to:
Confusion and personality changes
Drowsiness and sluggishness
Seizures
Coma (especially in advanced stages)
Can Acute Liver Failure be Prevented?
Yes, in many cases, acute liver failure is preventable. While some causes (like rare genetic conditions or autoimmune diseases) can't always be avoided, most cases result from things we can control, like medication misuse, alcohol abuse, or infections. Prevention starts with protecting your liver from damage and reducing exposure to known risks.
Avoid Excessive Alcohol Use
Long-term or heavy alcohol use weakens the liver and increases the risk of sudden liver failure, especially when combined with medications or illness.
Limit alcohol , no dose of alcohol is safe for human being
Avoid binge drinking and seek help for alcohol use disorder if you're struggling to cut back.
Use Medications Safely and Only as Prescribed
Many cases of ALF are caused by overdoses or misuse of medications, especially acetaminophen (paracetamol), which is safe in small doses but dangerous in high amounts.
Follow dosing instructions carefully, especially for over-the-counter pain relievers.
Never mix alcohol with medications that affect the liver.
Don’t take herbal supplements or alternative remedies without checking with a doctor ,they can also be toxic to the liver.
Talk to your doctor or pharmacist before combining medications.
Get Vaccinated Against Hepatitis
Hepatitis A and B are viral infections that can cause sudden and severe liver inflammation, sometimes leading to acute liver failure.
Get vaccinated, especially if you are at higher risk (traveling, healthcare work, chronic illness, etc.).
Practice safe sex and avoid sharing needles or personal items like razors or toothbrushes to reduce your risk of hepatitis B and C.
Avoid Harmful Chemicals and Environmental Toxins
Exposure to certain industrial chemicals, poisonous mushrooms (like Amanita phalloides), and toxic herbs can directly damage the liver and trigger failure.
Never eat wild mushrooms unless identified by an expert.
Wear protective gear when working with chemicals or solvents.
Store household and garden chemicals safely—away from children.
Be cautious with herbal products, especially those not regulated or tested.
Maintain Overall Liver Health
A healthy liver is more resilient to injury. Chronic conditions like obesity, diabetes, or hepatitis make the liver more vulnerable.
Eat a balanced diet and maintain a healthy weight.
Exercise regularly.
Avoid smoking and reduce alcohol intake.
Get regular check-ups, especially if you have a history of liver disease.
Choose Artemis Hospitals’ Department of Minimal Invasive HPB Surgery and Liver Transplant for Acute Liver Failure Treatment in Gurgaon-Delhi NCR, India
Artemis Hospital is one of the best hospitals in India, performing pure laparoscopic and pure robotic donor surgeries. We have a 100% record in donor safety surgeries by one of the best liver team surgeons in Gurgaon, Delhi-NCR, India. We offer ABOI ( blood group mismatch ) and swap Liver transplants for families with no blood group matching donor in the family.
Artemis Hospitals also offers state-of-the-art facilities and expert liver specialists dedicated to providing world-class treatment for Chronic Liver Disease. With a multidisciplinary approach, cutting-edge diagnostic tools, and personalised care, we ensure the best outcomes for patients planning to undergo liver transplant surgery. Whether the patient needs non-surgical management or a liver transplant, Artemis Hospitals is equipped with advanced treatments to cater to every need.
Expert Liver Transplant Surgeons
Artemis is home to one of the few surgical teams in the world that perform both pure laparoscopic and pure robotic liver donor surgery in India, with extensive experience in both adult and paediatric liver transplants. Our liver transplant surgeons have expertise to retrieve complex “ right posterior” and mono-segment liver grafts, which only select centres in India can perform this highly skilled Donor surgery. These specialists are trained in leading transplant centres and follow global best practices to ensure high success rates.
Advanced Technology & Surgical Infrastructure
The hospital features state-of-the-art modular operating theatres, dedicated transplant ICUs, and advanced imaging systems to support precision surgery and intensive post-operative monitoring. Robotic and minimally invasive techniques are also used in selected cases to reduce recovery time and improve outcomes.
Early intervention in liver disease can significantly improve survival outcomes and quality of life. Whether it’s managing advanced cirrhosis, evaluating transplant eligibility, or undergoing surgery, the liver transplant team at Artemis Hospitals offers expert, compassionate care backed by modern medical technology.
To book an appointment with some of the best liver surgeons at Artemis Hospitals, call +91-124-451-1111 or WhatsApp +91 9599285476. Appointments can also be scheduled through the online patient portal or via the Artemis Personal Health Record mobile app, available on both iOS and Android.
Reviewed By Dr. Giriraj Bora
Chief - Liver and Biliary Sciences, Organ Transplant
Artemis Hospitals
Frequently Asked Questions
How Long Can You Survive With Acute Liver Failure?
Survival depends on the cause, how quickly treatment begins, and whether a liver transplant is needed. Some people recover with prompt treatment, while others may not survive without a transplant.
How is Acute Liver Failure Different from Chronic Liver Disease?
Acute liver failure happens suddenly, while chronic liver disease develops over time. Chronic liver disease can lead to liver failure, but it’s usually a gradual process, unlike acute liver failure, which occurs quickly and often requires urgent care.
Can Hepatitis Viruses Cause Acute Liver Failure?
Yes, hepatitis viruses, especially hepatitis A, B, and C, can cause acute liver failure. These viruses damage the liver and can lead to sudden liver failure if not treated in time.
How Fast Can Acute Liver Failure Develop?
Acute liver failure can develop very quickly sometimes in a matter of days or weeks. It’s important to seek medical help right away if symptoms appear.
Is Acute Liver Failure Reversible?
If treated early, acute liver failure can be reversible. However, in severe cases, where the liver cannot recover, a liver transplant may be needed.
When is a Liver Transplant Needed in Acute Liver Failure?
A liver transplant is needed when the liver can no longer function, and other treatments are not effective. It’s usually the last resort for survival.
Can Alcohol Abuse Lead to Acute Liver Failure?
Yes, long-term heavy drinking can damage the liver and cause acute liver failure. Alcohol-related liver damage can happen suddenly in some cases, especially if combined with other factors like infections or medications.
How Long Is the Recovery Time for Acute Liver Failure?
Recovery time can vary. If a person’s liver heals with medical treatment, it could take weeks to months. If a liver transplant is needed, the recovery process can be longer and more complex.
What Are the Survival Rates for Acute Liver Failure?
Survival rates depend on the cause, how quickly treatment is started, and whether a liver transplant is needed. Early treatment improves survival chances, but the survival rate can be lower without a transplant.
Are There Any Warning Signs Before Acute Liver Failure Occurs?
There aren’t always warning signs. But if you notice yellowing of the skin or eyes, confusion, or severe fatigue, these could be signs that something is wrong with your liver. Seek medical help immediately if you have any of these symptoms.
How Does Acute Liver Failure Affect Other Organs?
Acute liver failure can affect other organs, especially the kidneys and brain. The buildup of toxins in the blood can cause kidney failure and brain swelling, leading to confusion or coma.
Is Acute Liver Failure Common in Children?
Although rare, acute liver failure can happen in children. Causes in children include viral infections, metabolic disorders, or toxins.
Who is the Best Doctor Near Me for Liver Failure Treatment?
Artemis Hospitals, Gurgaon, has some of the best gastroenterologists who specialize in diagnosing and treating with advanced medical care and personalized treatment plans tailored to your condition.
Which is the best hospital for Liver failure treatment in Gurgaon?
Artemis Hospitals is one of Gurgaon’s top multispecialty hospitals, offering expert liver care including accurate diagnosis, advanced treatment options, and long-term management.
What factors affect the cost of Liver failure treatment in Gurgaon?
The cost of liver treatment in Gurgaon depends on several factors such as the type of liver condition (hepatitis, cirrhosis, liver failure), the treatment approach (medications, procedures, or liver transplant), duration of care, hospital facilities, and the expertise of the treating doctor.
