What is Liver Disease? Causes and Symptoms of Liver Failure

Liver is the largest organ in the body. It weighs about 150 grams in a newborn and 1.5 kg in adults. It is located in the upper abdomen on the right side. It has tow lobes (right and left and it produces bile which flows into the small intestine (duodenum) via the bile duct.

Function of Liver:

  • Prepares and stores fuel like glycogen and fat soluble vitamins
  • Purifies blood
  • Makes bile that helps in the digestion and absorption of fat
  • Regulates metabolism and excretes drugs and toxins
  • Produces important proteins required for clotting of blood

How can liver get damaged in childhood and why does a child need liver transplantation?

The liver in children gets damaged due to various reasons.

  • Defects in the structure or function due to the absence of an enzyme/chemical since birth.
  • The common defect seen in children is biliary atresia where the bile duct that supplies bile into the intestine is not formed since birth.
  • These and other medical conditions can damage the liver of a newborn or a child, necessitating the need of a liver transplant.

What is Liver Disease

Common Liver Conditions:

1. Metabolic Liver Diseases

  • Wilson disease, wherein copper enzymes become defective.
  • Tyrosinemia, wherein the digestion of protein is defective.
  • Glycogen storage disorder.
  • Galactosemia, which is a defect in the digestion of carbohydrates.

2. Viral Infections

  • The liver can also be affected due to infections like viral hepatitis A, E, B, C, typhoid, dengue etc.
  • 1:1000 cases of viral hepatitis A and E can turn serious and go into liver failure.

3. Autoimmune Conditions
Occasionally autoimmune conditions wherein the body develops antibodies against its own liver cells can also result in liver damage in a child.

4. Lifestyle Causes
One of the growing conditions of liver disease in children is fatty liver disease, which is mostly seen in overweight and obese children. With the increasing incidence of unhealthy eating habits such s fried and fast food, consumption of soft drinks, decreased outdoor physical activities, children face the problem of obesity which paves the way of fatty liver disease.

5. Medications
Indiscriminate use of medications can result in liver damage as seen in anti-tuberculosis and anti-epileptic drugs.

6. Tumor
There have also been rare cases of the liver in a child being affected due to tumors.

Note: In adults the common causes liver damage are alcohol, infections like hepatitis B, C and tumors.

Symptoms of Liver Failure:
Lethargy, irritability, abnormal behavior, reversibility of sleep rhythm, excessive sleep, abnormal breathing, hyperventilation, altered sensorium (coma in advance cases), jaundice, bluish spots on the body, decreased urine output, etc.

Tests to Determine Liver Failure:
The most important blood test depicting liver failure in children is prolonged prothrombin time/INR.

Management of Liver Failure:
When acute liver failure is suspected, the patient should be managed in a tertiary care health center. Aggressive management could salvage 50-60 per cent of the liver with medical therapy while the rest would need liver transplantation. If untreated, it has higher chances of mortality.

What is Liver Transplantation:
Liver transplantation is the replacement of diseased liver with a healthy liver from a deceased donor or a living donor, nowadays, liver transplantation is a well-accepted treatment option for end-stage liver disease and acute liver failure with a 95 per cent success rate. Liver transplantation is potentially applicable to any acute or chronic condition resulting in irreversible liver dysfunction, provided that the recipient does not have other conditions that will preclude a successful transplant. Besides this, it is indicated for liver tumors and certain inborn errors of metabolism in children.

One of the growing conditions of liver disease in children is fatty liver disease, which is mostly seen in overweight and obese children.

How Safe is Liver Donation:
A healthy adult has nearly 70 per cent extra liver and a healthy liver is the only organ which regenerates. There are two lobes of the liver. One can donate a part of his/her liver and the liver would regenerate >50 per cent in a month and >80 per cent within three months of donation.

Preventive Measures to Avoid Liver Problems:

  • Consumption of clean water and clean food (to avoid infections such as typhoid, hepatitis A)
  • Getting vaccinated with Hepatitis B and A vaccines
  • Following healthy eating habits (avoid junk food such as chips, samosas, patties, burgers, too much biscuits etc. which can give rise to obesity)
  • Regular intake of vegetables and fruits
  • Exercising and taking part in sports
  • Taking care to not come in contact with contaminated needles/syringes and ensuring that blood transfusions are done in a credible hospital

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