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End-Stage Liver Disease (ESLD)
in Denver

What is End-Stage Liver Disease?

End-stage liver disease (ESLD), also called chronic liver failure, refers to irreversible damage to the liver and the way it functions. Chronic liver failure can take months or years to develop. A slow decline in liver function along with severe scarring of the liver, called cirrhosis, is what ultimately leads to liver failure.

The signs of chronic liver failure can be divided into early symptoms and advanced symptoms, and may consist of the following:

Early Symptoms

  • Fatigue
  • Nausea or vomiting
  • Loss of appetite
  • Mild abdominal discomfort

Advanced symptoms

  • Bruising or bleeding easily
  • Confusion or disorientation
  • Yellowing of the skin or eyes (jaundice)
  • Dark urine
  • Severely itchy skin
  • Buildup of fluid in the arms, legs or abdomen

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Stages of Liver Failure

There are different stages of liver failure, which increasingly affect the liver’s ability to function. These stages include:

1.       Inflammation: This is an early stage, in which the liver is enlarged or inflamed.

2.       Fibrosis: Scar tissue will begin to replace healthy tissue in the inflamed liver.

3.       Cirrhosis: Scar tissue buildup is severe, and has made it difficult for the liver to function normally.

4.       End-stage liver disease: Liver function has dramatically deteriorated, and the damage cannot be reversed.

5.       Liver cancer: While liver cancer can occur at any stage of liver failure, people with cirrhosis are at an increased risk for developing it.

How is End-Stage Liver Disease Diagnosed?

Diagnosis of liver failure is usually done through a variety of diagnostic tests. Your doctor may recommend you undergo liver blood tests or other blood tests to see how your liver is functioning, as well as imaging tests or a biopsy of the liver.

Treatment Options for End-Stage Liver Disease

Once the liver has reached end-stage liver disease, it has endured too much damage to be healed. Because of this, the only treatment option for many patients is a liver transplant. This involves removing the diseased liver and replacing it with a healthy donor liver.

The liver transplant process first involves meeting certain criteria. In order to meet these criteria, you must have a liver that is not working properly and has damage that is beyond repair. You will also need a pretransplant evaluation which may include certain testing, as well as a financial and insurance evaluation. After these evaluations are complete, the liver transplant selection committee will review your results and will decide if a transplant is right for you. If you are approved you will be put on a waiting list for a healthy donor liver, after which surgery can be performed.

Liver Failure FAQs

Can liver failure be reversed?

The first and second stages of liver failure (inflammation and fibrosis) can be reversed with proper treatment. Once cirrhosis develops, the progression of the disease can be slowed, but the scarring is still irreversible.

How common is liver failure?

According to the CDC, in 2023, approximately 4.5 million people in the US (1.8%) had some form of liver disease, and about 57,000 people died from it in 2022. These deaths are mainly due to complications from cirrhosis. Deaths related to alcohol-associated liver disease have been steadily rising over the past 10 years and increased significantly during the first year of the COVID-19 pandemic.

How long can someone live with liver failure?

How long someone can live with liver failure depends on what stage of liver failure they have, the cause of the liver failure, and the treatment available for the liver failure.

How does liver failure happen?

There are four stages of liver disease progression. The first stage is inflammation, where the liver may be enlarged and inflamed. The second stage is fibrosis or scarring, where scar tissue starts to replace healthy liver tissue. The third stage is cirrhosis, which occurs when scar tissue forms throughout the entire liver and may lead to liver dysfunction. The last stage is end-stage liver disease, where the liver scarring/damage is not reversable, and the liver cannot function properly.

What are the early signs of liver failure?

Early signs of liver damage can include nausea and fatigue, but sometimes, patients experience no symptoms. Other early signs can include loss of appetite, discomfort in the upper right side of the abdomen and unexplained weight loss.

What are the symptoms of liver failure?

Liver failure can be acute (sudden) or chronic (gradual in onset). Some symptoms of liver failure include fatigue, nausea, loss of appetite, yellowing of the skin, vomiting blood, blood in the stool, pale stools and swelling in the belly or legs. For those with acute liver failure, symptoms may also include a change in mental status or confusion or sweet breath odor. If you are experiencing any unusual symptoms, contact our Lone Tree, Englewood, Castle Rock or Parker office to schedule an appointment with one of our gastroenterologists.

What causes liver failure?

Liver failure can be caused by a number of issues. Some of the causes include fatty liver or metabolic liver disease, alcohol related liver disease from heavy and continued alcohol use, viral liver infections, toxins, autoimmune diseases, metabolic conditions and certain cardiovascular diseases.

How do you prevent liver failure?

There are many ways to prevent liver damage and liver failure, including moderating your alcohol use, getting vaccinated for hepatitis B, maintaining a healthy lifestyle and following instructions on taking medications like acetaminophen (Tylenol). You'll also want to have a physical every year with a screening for obesity, high cholesterol, high blood pressure and diabetes.

What are the treatment options for liver failure?

Once the liver has progressed to the end stage of liver disease, the liver is beyond repair. Treatment includes using medications to control the symptoms of liver disease or cure of the liver disease with a liver transplant. The SDG provider team has expertise in treating all liver diseases, including liver failure, so if you've been diagnosed with liver failure and are in need of a second opinion, schedule a consultation today.

Your South Denver GI Team

At South Denver GI, our team of physicians and advanced practice providers have the expertise to provide you with outstanding care. If you would like to learn more about End-Stage Liver Disease (ESLD) or need to schedule an appointment at our office, contact us today!

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