Print OverviewAcute liver failure is loss of liver function that happens quickly — in days or weeks — usually in a person who has no preexisting liver disease. It's most often caused by a hepatitis virus or drugs, such as acetaminophen. Acute liver failure is less common than chronic liver failure, which develops more slowly. Acute liver failure, also known as fulminant hepatic failure, can cause serious complications, including bleeding and increased pressure in the brain. It's a medical emergency that requires hospitalization. Depending on the cause, acute liver failure can sometimes be reversed with treatment. In many situations, though, a liver transplant may be the only cure.Products & ServicesA Book: Mayo Clinic Family Health BookNewsletter: Mayo Clinic Health Letter — Digital EditionShow more products from Mayo Clinic SymptomsSymptoms of acute liver failure may include: Yellowing of the skin and eyeballs, called jaundice. Pain in the upper right belly area, called the abdomen. A swollen belly, known as ascites. Nausea and vomiting. A general sense of feeling unwell, known as malaise. Disorientation or confusion. Sleepiness. Breath with a musty or sweet odor. Tremors. When to see a doctorAcute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin; tenderness in the upper belly; or any unusual changes in mental state, personality or behavior, seek medical attention right away. Request an appointment There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. From Mayo Clinic to your inbox Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview. 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Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry CausesAcute liver failure occurs when liver cells are seriously damaged and are no longer able to function. Possible causes include: Acetaminophen overdose. Taking too much acetaminophen (Tylenol, others) is the most common cause of acute liver failure in the United States. Outside of the United States, acetaminophen is known as paracetamol. Acute liver failure can happen after one very large dose of acetaminophen, or after higher than recommended doses every day for several days. If you or someone you know has taken an overdose of acetaminophen, seek medical attention as quickly as possible. Treatment may prevent liver failure. Don't wait for the symptoms of liver failure. Hepatitis and other viruses. Hepatitis A, hepatitis B and hepatitis E increase the risk of acute liver failure. Other viruses that can increase risk include Epstein-Barr virus, cytomegalovirus and herpes simplex virus. Prescription medicines. Some prescription medicines, including antibiotics, nonsteroidal anti-inflammatory drugs and anticonvulsants, can cause acute liver failure. Herbal supplements. Herbal drugs and supplements, including kava, ephedra, skullcap and pennyroyal, have been linked to acute liver failure. Toxins. Toxins that can cause acute liver failure include the poisonous wild mushroom Amanita phalloides, which is sometimes mistaken for one that is safe to eat. Carbon tetrachloride is another toxin that can cause acute liver failure. It is an industrial chemical found in refrigerants and solvents for waxes, varnishes and other materials. Autoimmune disease. Liver failure can be caused by autoimmune hepatitis — a disease in which the immune system attacks liver cells, causing inflammation and injury. Diseases of the veins in the liver. Vascular diseases, such as Budd-Chiari syndrome, can cause blockages in the veins of the liver and lead to acute liver failure. Metabolic disease. Rare metabolic diseases, such as Wilson's disease and acute fatty liver of pregnancy, sometimes cause acute liver failure. Cancer. Cancer that either begins in or spreads to the liver can cause the liver to fail. Shock. Overwhelming infection, called sepsis, and shock can severely reduce blood flow to the liver, causing liver failure. Heat stroke. Extreme physical activity in a hot environment can trigger acute liver failure. Some cases of acute liver failure have no obvious cause. Risk factorsRisk factors for acute liver failure include: Being female. A majority of people affected by acute liver failure are female. Underlying illness. Many conditions, including viral hepatitis, metabolic disease, autoimmune disease and cancer can increase the risk of acute liver failure. ComplicationsAcute liver failure often causes complications, including: Too much fluid in the brain, called cerebral edema. Too much fluid causes pressure to build up in the brain, which can lead to disorientation, severe mental confusion and seizures. Bleeding and bleeding disorders. A failing liver cannot make enough clotting factors, which help blood to clot. Bleeding in the gastrointestinal tract is common with this condition. It may be difficult to control. Infections. People with acute liver failure are more likely to develop infections, particularly in the blood and in the respiratory and urinary tracts. Kidney failure. Kidney failure often occurs after liver failure, especially with an acetaminophen overdose, which damages both the liver and the kidneys. PreventionReduce your risk of acute liver failure by taking care of your liver. Follow instructions on medicines. If you take acetaminophen or other medicines, check the package insert for the recommended dose, and don't take more than that. If you already have liver disease, ask your healthcare team if it is safe to take any amount of acetaminophen. Tell your healthcare team about all your medicines. Even nonprescription and herbal medicines can interact with prescription drugs you're taking. Drink alcohol in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Avoid risky behavior. Get help if you use illicit intravenous drugs. Don't share needles. Use condoms during sex. If you get tattoos or body piercings, make sure the shop you choose is clean and safe. Don't smoke. Get vaccinated. If you have chronic liver disease, a history of any type of hepatitis infection or an increased risk of hepatitis, talk to your care team about getting the hepatitis B vaccine. A vaccine also is available for hepatitis A. Be careful not to come into contact with other people's blood and body fluids. Accidental needle sticks or improper cleanup of blood or body fluids can spread hepatitis viruses. Sharing razor blades or toothbrushes also can spread infection. Don't eat wild mushrooms. It can be difficult to tell the difference between a poisonous mushroom and one that is safe to eat. Take care with aerosol sprays. When you use an aerosol cleaner, make sure the room is ventilated, or wear a mask. Take similar protective measures when spraying insecticides, fungicides, paint and other toxic chemicals. Follow product instructions carefully. Watch what gets on your skin. When using insecticides and other toxic chemicals, cover your skin with gloves, long sleeves, a hat and a mask. Maintain a healthy weight. Obesity can cause a condition called nonalcoholic fatty liver disease (NAFLD), now called metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD may lead to serious liver damage. The Mayo Clinic experience and patient stories Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients. Jerry Costello starts life after public service with new liverJerry Costello holds his first great-great-grandchild, Colt Keen. Jerry Costello has spent a lifetime serving his community and country. After retiring, the southwestern Illinois native was looking forward to a new chapter. He started his own business and enjoyed more time at home with his family. But in 2017, Jerry noticed weight gain without a change in diet. "I went to my doctor for my annual physical and underwent a series of tests, but had… By Mayo Clinic Staff Request an appointment Diagnosis & treatment Oct. 15, 2024 Print Living with acute liver failure? Connect with others like you for support and answers to your questions in the Transplants support group on Mayo Clinic Connect, a patient community. Transplants Discussions Anyone waiting for liver transplant and diagnosed with liver cancer? 26 Replies Thu, Nov 21, 2024 chevron-right Liver transplant - Let's support each other 1617 Replies Wed, Nov 13, 2024 chevron-right Transplant anti-rejection medications. What's your advice? 362 Replies Sun, Nov 10, 2024 chevron-right See more discussions Show references Feldman M, et al., eds. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed July 2, 2024. Acute liver failure. Merck Manual Professional Version. https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/acute-liver-failure. Accessed July 2, 2024. Stravitz RT, et al. Acute liver failure. The Lancet. 2019; doi:10.1016/S0140-6736(19)31894-X. Goldberg E, et al. Acute liver failure in adults: Management and prognosis. https://www.uptodate.com/contents/search. Accessed July 2, 2024. Bezinover D, et al., eds. Liver assist systems for bridging to transplantation: Devices and concepts. In: Critical Care for Potential Liver Transplant Candidates. Springer; 2019. 13 ways to a healthy liver. American Liver Foundation. https://liverfoundation.org/resource-center/blog/13-ways-to-a-healthy-liver/. Accessed July 2, 2024. Picco MF (expert opinion). Mayo Clinic. Oct. 6, 2020. Ferri FF. Acute liver failure. In: Ferri's Clinical Advisor 2025. Elsevier; 2025. https://www.clinicalkey.com. Accessed July 23, 2024. Related Associated Procedures Liver biopsy Liver function tests Liver transplant Ultrasound Show more associated procedures News from Mayo Clinic Researchers find promise in new potential treatment for liver failure March 14, 2024, 04:30 p.m. CDT Products & Services A Book: Mayo Clinic Family Health Book Newsletter: Mayo Clinic Health Letter — Digital Edition Show more products and services from Mayo Clinic Acute liver failureSymptoms&causesDiagnosis&treatmentDoctors&departments Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 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